Carvedilol for reducing portal pressure in primary prophylaxis of variceal bleeding: a dose-response study

Alimentary Pharmacology & Therapeutics
R SchwarzerArnulf Ferlitsch

Abstract

Sequential measurements of hepatic venous pressure gradient (HVPG) are used to assess the haemodynamic response to nonselective betablockers (NSBBs) in patients with portal hypertension. To assess the rates of HVPG response to different doses of carvedilol. Consecutive patients with cirrhosis undergoing HVPG-guided carvedilol therapy for primary prophylaxis of variceal bleeding between 08/2010 and 05/2015 were retrospectively included. After baseline HVPG measurement, carvedilol 6.25 mg/d was administered and HVPG response (HVPG-decrease ≥20% or to ≤12 mm Hg) was assessed after 3-4 weeks. In case of nonresponse, carvedilol dose was increased to 12.5 mg/d and a third HVPG-measurement was performed after 3-4 weeks. We also assessed HVPG-response rates according to the Baveno VI consensus (HVPG decrease ≥10% or to ≤12 mm Hg) and changes in systolic arterial pressure (SAP). Seventy-two patients (Child A, 37%; B, 35%; C, 28%) were included. 28 (39%) patients achieved a HVPG-decrease ≥ 20% with carvedilol 6.25 mg/d and another 10 (14%) with carvedilol 12.5 mg/d. Forty (56%) patients had a HVPG decrease ≥10% with carvedilol 6.25 mg/d and 24 (33%) with carvedilol 12.5 mg/d. Thus, in total, a HVPG-response of ≥20% and ≥10% and was achie...Continue Reading

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Citations

Nov 14, 2018·European Journal of Gastroenterology & Hepatology·Feng ZhangYuzheng Zhuge
Apr 13, 2018·Alimentary Pharmacology & Therapeutics·D Tripathi, A J Stanley
Apr 13, 2018·Alimentary Pharmacology & Therapeutics·T Reiberger, A Ferlitsch
Oct 11, 2020·Journal of Evidence-based Medicine·Dmitry Victorovich Garbuzenko, Nikolay Olegovich Arefyev
Apr 6, 2019·Mayo Clinic Proceedings·Douglas A SimonettoPatrick S Kamath
Apr 12, 2021·Clinics in Liver Disease·Mattias Mandorfer, Benedikt Simbrunner
Apr 12, 2021·Clinics in Liver Disease·Mathias Jachs, Thomas Reiberger
Aug 10, 2021·World Journal of Hepatology·Nikolaus PfistererThomas Reiberger
Sep 30, 2020·Journal of Clinical Gastroenterology·Georgios N KalambokisHaralampos Milionis

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