Session 6: Prevention of Rebleeding

Randomized, controlled trial of carvedilol versus nadolol plus isosorbide mononitrate for the prevention of variceal rebleeding

“…As a whole, no significant difference could be observed in either rebleeding from upper gastrointestinal tract, esophageal varices or gastroesophageal varices between both treatment groups. The 43% esophageal variceal rebleeding rate in our patients receiving nadolol plus ISMN was similar to previous reports . The frequency of gastroesophageal variceal rebleeding was 54% in the carvedilol group and 57% in the N + I group.…”

“…Numerous measures have been adopted for the prevention of variceal rebleeding . All of non‐selective beta blockers, EVL or combination of EVL with beta blockers have been recommended to be a plausible first‐line approach for preventing recurrent bleeding . Among them, combination of EVL and beta blockers may be the most effective method to reduce variceal rebleeding .…”

“…All of non‐selective beta blockers, EVL or combination of EVL with beta blockers have been recommended to be a plausible first‐line approach for preventing recurrent bleeding . Among them, combination of EVL and beta blockers may be the most effective method to reduce variceal rebleeding . On the other hand, the use of EVL still carries a risk of inducing ulcer bleeding and other complications .…”

“…Combination of beta‐blockers and ISMN has been widely used in the prevention of esophageal variceal rebleeding . Comparison between beta‐blockers and combination of beta‐blockers and ISMN showed that variceal rebleeding rate was around 40–51% in patients receiving combination therapy, slightly lower than that achieved by propranolol alone . However, the incidence of adverse events was significantly higher in patients treated with combination therapy, resulting in a high incidence of incompliance .…”