A randomised controlled study of propranolol for prevention of recurrent gastrointestinal bleeding in patients with cirrhosis.
74 cirrhotic patients with a history of variceal or gastric bleeding were randomly assigned to treatment with propranolol (40 to 360 mg/day) or placebo. The patients were all in good condition and doses of propranolol were titrated until a 25% reduction in heart rate was achieved. After 2 years, the cumulative percentage of patients free from rebleeding was significantly greater among the patients receiving propranolol (79%) than in the placebo group (32%; p less than 0.0001). Similarly, the percentage of surviving patients was significantly greater with propranolol (90%) than with placebo (57%; p less than 0.02) after 2 years. It was concluded that in cirrhotic patients in good condition, propranolol reduced both the risk of recurrent gastrointestinal haemorrhage and the mortality rate during a 2-year period of continuous administration of the drug.
Lebrec
D
D
Unité de Recherches de Physiopathologie Hépatique (INSERM), Hôpital Beaujon, Clichy, France.
Poynard
T
T
Bernuau
J
J
Bercoff
E
E
Nouel
O
O
Capron
J P
JP
Poupon
R
R
Bouvry
M
M
Rueff
B
B
Benhamou
J P
JP
D000328:Adult; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D011433:Propranolol / Q000009:adverse effects / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D016019:Survival Analysis
D011433:Propranolol