The effects of carvedilol a nonselective beta —blocker on portal hemodynamics in cirrhosis

Fierbinţeanu-Braticevici, Carmen; Udeanu, Maria; Andronescu, D

doi:10.1016/s0168-8278(03)80597-4

Cited by 1 publication

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“…Five publications were excluded: two were published as Master's theses referring to one trial, which reported largely different results, and the methods of randomisation were questionable; 17 18 one was a non-randomised trial; 19 one was irrelevant to our topic; 20 and one included non-cirrhotic participants. 21 Finally, of the remaining 33 publications, 25 referring to 12 trials were included in the quantitative synthesis; 10 16 22–31 3 referring to 2 trials were awaiting classification, 32 33 and 5 referring to 4 trials were ongoing projects ( figure 1 ). 34–37 …”

Section: Resultsmentioning

confidence: 99%

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Carvedilol for portal hypertension in cirrhosis: systematic review with meta-analysis

Sun

et al. 2016

BMJ Open

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ObjectiveTo assess the clinical and haemodynamic effects of carvedilol for patients with cirrhosis and portal hypertension.DesignA systematic review and meta-analysis.Data sourcesWe searched PubMed, Cochrane library databases, EMBASE and the Science Citation Index Expanded through December 2015. Only randomised controlled trials (RCTs) were included.Outcome measureWe calculated clinical outcomes (all-cause mortality, bleeding-related mortality, upper gastrointestinal bleeding) as well as haemodynamic outcomes (hepatic venous pressure (HVPG) reduction, haemodynamic response rate, post-treatment arterial blood pressure (mean arterial pressure; MAP) and adverse events).Results12 RCTs were included. In 7 trials that looked at haemodynamic outcomes compared carvedilol versus propranolol, showing that carvedilol was associated with a greater reduction (%) of HVPG within 6 months (mean difference −8.49, 95% CI −12.36 to −4.63) without a greater reduction in MAP than propranolol. In 3 trials investigating differences in clinical outcomes between carvedilol versus endoscopic variceal band ligation (EVL), no significant differences in mortality or variceal bleeding were demonstrated. 1 trial compared clinical outcomes between carvedilol versus nadolol plus isosorbide-5-mononitrate (ISMN), and showed that no significant difference in mortality or bleeding had been found. 1 trial comparing carvedilol versus nebivolol showed a greater reduction in HVPG after 14 days follow-up in the carvedilol group.ConclusionsCarvedilol may be more effective in decreasing HVPG than propranolol or nebivolol and it may be as effective as EVL or nadolol plus ISMN in preventing variceal bleeding. However, the overall quality of evidence is low. Further large-scale randomised studies are required before we can make firm conclusions.Trial registration numberCRD42015020542.

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Section: Resultsmentioning

confidence: 99%

“…There were two studies awaiting classification. 32 33 Both trials had been completed, but no full text had yet been published, and data from the abstracts could not be used directly. We received no reply after requesting data (online supplementary appendix 9 ).…”

Section: Resultsmentioning

confidence: 99%

Carvedilol for portal hypertension in cirrhosis: systematic review with meta-analysis

Sun

et al. 2016

BMJ Open

View full text Add to dashboard Cite

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The effects of carvedilol a nonselective beta —blocker on portal hemodynamics in cirrhosis

Cited by 1 publication

References 0 publications

Carvedilol for portal hypertension in cirrhosis: systematic review with meta-analysis

Carvedilol for portal hypertension in cirrhosis: systematic review with meta-analysis

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