PMID- 23278466
OWN - NLM
STAT- MEDLINE
DCOM- 20130924
LR  - 20181202
IS  - 1440-1746 (Electronic)
IS  - 0815-9319 (Linking)
VI  - 28
IP  - 4
DP  - 2013 Apr
TI  - Controlled trial of ligation plus vasoconstrictor versus proton pump inhibitor in 
      the control of acute esophageal variceal bleeding.
PG  - 684-9
LID - 10.1111/jgh.12107 [doi]
AB  - BACKGROUND: Endoscopic therapy combined with vasoconstrictor was generally 
      recommended to treat acute variceal bleeding. However, up to 30% of patients may 
      still encounter treatment failure. OBJECTIVES: This trial was to evaluate the 
      efficacy of combination with endoscopic variceal ligation (EVL) and proton pump 
      inhibitor (PPI) infusion in patients with acute variceal bleeding. METHODS: 
      Cirrhotic patients presenting with acute esophageal variceal bleeding were 
      rescued by emergency EVL. Soon after arresting of bleeding varices, eligible 
      subjects were randomized to two groups. Vasoconstrictor group received either 
      somatostatin or terlipressin infusion. PPI group received either omeprazole or 
      pantoprazole. End points were initial hemostasis, very early rebleeding rate, and 
      adverse events. RESULTS: Sixty patients were enrolled in vasoconstrictor group 
      and 58 patients in PPI group. Both groups were comparable in baseline data. 
      Initial hemostasis was achieved in 98% in vasoconstrictor group and 100% in PPI 
      group (P = 1.0). Very early rebleeding within 48-120 h occurred in one patient 
      (2%) in vasoconstrictor group and one patient (2%) in the PPI group (P = 1.0). 
      Treatment failure was 4% in vasoconstrictor group and 2% in PPI group (P = 0.95). 
      Adverse events occurred in 33 patients (55%) in vasoconstrictor group and three 
      patients (6%) in PPI group (P < 0.001). Two patients in vasoconstrictor group and 
      one patient in PPI group encountered esophageal ulcer bleeding. CONCLUSIONS: 
      After successful control of acute variceal bleeding by EVL, adjuvant therapy with 
      PPI infusion was similar to combination with vasoconstrictor infusion in terms of 
      initial hemostasis, very early rebleeding rate, and associated with fewer adverse 
      events.
CI  - (c) 2012 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing 
      Asia Pty Ltd.
FAU - Lo, Gin-Ho
AU  - Lo GH
AD  - Department of Medical Research, Digestive Center, E-DA Hospital, Kaohsiung, 
      Taiwan. ghlo@kimo.com
FAU - Perng, Daw-Shyong
AU  - Perng DS
FAU - Chang, Chi-Yang
AU  - Chang CY
FAU - Tai, Chi-Ming
AU  - Tai CM
FAU - Wang, Huay-Min
AU  - Wang HM
FAU - Lin, Hui-Chen
AU  - Lin HC
LA  - eng
SI  - ClinicalTrials.gov/NCT01112852
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - Australia
TA  - J Gastroenterol Hepatol
JT  - Journal of gastroenterology and hepatology
JID - 8607909
RN  - 0 (2-Pyridinylmethylsulfinylbenzimidazoles)
RN  - 0 (Proton Pump Inhibitors)
RN  - 0 (Vasoconstrictor Agents)
RN  - 50-57-7 (Lypressin)
RN  - 51110-01-1 (Somatostatin)
RN  - 7Z5X49W53P (Terlipressin)
RN  - D8TST4O562 (Pantoprazole)
RN  - KG60484QX9 (Omeprazole)
SB  - IM
MH  - 2-Pyridinylmethylsulfinylbenzimidazoles/adverse effects/therapeutic use
MH  - Adult
MH  - Aged
MH  - Combined Modality Therapy
MH  - Esophageal and Gastric Varices/mortality/*therapy
MH  - Esophagoscopy
MH  - Female
MH  - Gastrointestinal Hemorrhage/mortality/*therapy
MH  - Hemostasis
MH  - Humans
MH  - Ligation
MH  - Lypressin/adverse effects/analogs & derivatives/therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Omeprazole/adverse effects/therapeutic use
MH  - Pantoprazole
MH  - Proton Pump Inhibitors/adverse effects/*therapeutic use
MH  - Recurrence
MH  - Somatostatin/adverse effects/therapeutic use
MH  - Terlipressin
MH  - Treatment Outcome
MH  - Vasoconstrictor Agents/adverse effects/*therapeutic use
EDAT- 2013/01/03 06:00
MHDA- 2013/09/26 06:00
CRDT- 2013/01/03 06:00
PHST- 2012/12/03 00:00 [accepted]
PHST- 2013/01/03 06:00 [entrez]
PHST- 2013/01/03 06:00 [pubmed]
PHST- 2013/09/26 06:00 [medline]
AID - 10.1111/jgh.12107 [doi]
PST - ppublish
SO  - J Gastroenterol Hepatol. 2013 Apr;28(4):684-9. doi: 10.1111/jgh.12107.