Nadelel plus spironolactone vs nadolol alone in the prophylaxis of the first variceal bleeding in non-ascitic cirrhotic patients. A prospective, multicenter, double blind and randomized trial

Abecasis, Raquel; Kravetz, David; Fassio, E; B, Ameigeiras; García, Daniel; Isla, Rogelio; Landeira, Graciela; Romero, Gustavo; Terg, Rubén

doi:10.1016/s0016-5085(08)80012-1

Cited by 1 publication

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“…In clinical practice the use of spironolactone, like propranolol, may be limited by its side effects, particularly painful gynaecomastia which was present in 55% of male patients in one series 84 . There are no published clinical trials assessing the efficacy of spironolactone in preventing variceal bleeding, although an ongoing study is comparing nadolol monotherapy with nadolol and spironolactone combination therapy in the primary prevention of variceal bleeding 85 . Initial results show no differences in the bleeding rate in the two groups.…”

Section: Haemodynamic Studiesmentioning

confidence: 99%

A drug therapy for the prevention of variceal haemorrhage

Tripathi

Hayes

2001

Aliment Pharmacol Ther

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The development of varices is a major complication of cirrhosis, and variceal haemorrhage has a high mortality. There have been major advances in the primary and secondary prevention of variceal haemorrhage over the last 20 years involving endoscopic, radiological and pharmacological approaches. This review concentrates principally on drug therapy, particularly on the numerous haemodynamic studies. Many of these drugs have not been studied in clinical trials, but provide data about the underlying pathogenesis of portal hypertension. Also covered in this review are the randomized controlled trials and meta‐analyses that involve a large number of patients. These trials involve relatively few drugs such as non‐selective beta‐blockers and nitrates. Correlations between haemodynamic and clinical parameters are discussed. Despite the recent increase in the use of alternative endoscopic therapies, an effective and well tolerated drug remains a clinically important research goal.

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Section: Haemodynamic Studiesmentioning

confidence: 99%