Efficacy of octreotide and sclerotherapy in the treatment of acute variceal bleeding in cirrhotic patients. A prospective, multicentric, and randomized clinical trial.
BACKGROUND
Sclerotherapy is the most widely used method for treatment of acute variceal bleeding. Previous reports have suggested that octreotide infusion is as effective as sclerotherapy. Our aim was to investigate the efficacy and safety of octreotide in comparison with sclerotherapy in controlling variceal bleeding.


METHODS
Seventy-six cirrhotic patients were randomized to receive either sclerotherapy (n = 37) or octreotide (n = 39) infusion of 50 microg/h intravenously for 48 h after a bolus of 100 microg, followed by subcutaneous injection of 100 microg/8 h for an additional 72 h.


RESULTS
The two groups were similar in base-line data. A similar initial control of bleeding was obtained in 94.6% for sclerotherapy and 84.6% for octreotide (NS). No difference was observed between sclerotherapy and octreotide in rebleeding (23% versus 33%) and treatment failure (22% versus 36%, respectively). Furthermore, the overall success of treatment was 78% for sclerotherapy and 64% for octreotide. No significant difference in mortality was observed between treatments (eight patients for octreotide and three patients for sclerotherapy, NS).


CONCLUSIONS
These results show that both treatments present a very high and similar initial and final control of bleeding. However, there is a trend that could be clinically important towards better results in the patients treated with sclerotherapy.
Bildozola
M
M
Liver Unit, Hospital de Gastroenterologia B. Udaondo, Buenos Aires, Argentina.
Kravetz
D
D
Argonz
J
J
Romero
G
G
Suarez
A
A
Jmelnitzky
A
A
Fainberg
M
M
Fassio
E
E
Berreta
J
J
Romero
G
G
Landeira
G
G
Martinez
H
H
Bosco
A
A
Guevara
M
M
Valero
J
J
Chopita
N
N
Berenstein
G
G
Terg
R
R
D000208:Acute Disease; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D004932:Esophageal and Gastric Varices / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006471:Gastrointestinal Hemorrhage / Q000188:drug therapy / Q000628:therapy*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use*; D011446:Prospective Studies; D012008:Recurrence; D015911:Sclerotherapy; D016896:Treatment Outcome
D005765:Gastrointestinal Agents; D015282:Octreotide