title: [A prospective study comparing the efficacy of early administration of terlipressin and somatostatin for the control of acute variceal bleeding in patients with cirrhosis].
abstract: OBJECTIVE
  Terlipressin and somatostatin decrease portal venous pressure and they are used for the treatment of variceal bleeding. However, only a few studies have compared the efficacy of these drugs in combination with other procedures for hemostasis. Therefore, we performed a prospective study to compare the efficacy of terlipressin and somatostatin for controlling acute variceal bleeding when used in combination with other procedures for hemostasis.
  
  
  METHODS
  A total of 98 patients, who presented with variceal bleeding from September 2003 to May 2005, were randomly divided into the somatostatin group or terlipressin group. We compared the 5-day failure rate (defined as failure to control bleeding, rebleeding or death within 5 days of admission) and the 6-week mortality. The prognostic factors for 5-day failure and 6-week mortality were also evaluated.
  
  
  RESULTS
  There were no differences in baseline characteristics between the two groups. The overall 5-day failure rate and the cumulative 6-week mortality were 16.3% and 15.8%, respectively. The five-day failure rate and the cumulative 6-week mortality were not significantly different between the somatostatin and terlipressin groups. Hepatocellular carcinoma, the baseline serum creatinine level and endoscopic treatment for hemostasis were the significant predictors of 5-day failure; the baseline serum creatinine level was the predictor of 6-week mortality.
  
  
  CONCLUSIONS
  Both somatostatin and terlipressin were effective and showed comparable efficacy for the control of the acute variceal bleeding in the setting of a combined therapeutic approach. The baseline serum creatinine level may be a significant predictor for patient failure at 5 days and the 6-week mortality.
authors.affiliation: Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea.
authors.forename: Yeon Seok
authors.initials: YS
authors.lastname: Seo
authors.forename: Soon Ho
authors.initials: SH
authors.lastname: Um
authors.forename: Jong Jin
authors.initials: JJ
authors.lastname: Hyun
authors.forename: Youn Ho
authors.initials: YH
authors.lastname: Kim
authors.forename: Sanghoon
authors.initials: S
authors.lastname: Park
authors.forename: Bo Ra
authors.initials: BR
authors.lastname: Keum
authors.forename: Yong Sik
authors.initials: YS
authors.lastname: Kim
authors.forename: Yoon Tae
authors.initials: YT
authors.lastname: Jeen
authors.forename: Hong Sik
authors.initials: HS
authors.lastname: Lee
authors.forename: Hoon Jai
authors.initials: HJ
authors.lastname: Chun
authors.forename: Sang Woo
authors.initials: SW
authors.lastname: Lee
authors.forename: Jai Hyun
authors.initials: JH
authors.lastname: Choi
authors.forename: Chang Duck
authors.initials: CD
authors.lastname: Kim
authors.forename: Ho Sang
authors.initials: HS
authors.lastname: Ryu
mesh_terms: D000208:Acute Disease; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications; D004932:Esophageal and Gastric Varices / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000150:complications / Q000188:drug therapy*; D006470:Hemorrhage / Q000150:complications / Q000188:drug therapy; D016558:Hemostasis, Endoscopic; D006801:Humans; D008099:Liver / Q000098:blood supply*; D008103:Liver Cirrhosis / Q000150:complications*; D008107:Liver Diseases / Q000188:drug therapy; D008113:Liver Neoplasms / Q000150:complications; D008236:Lypressin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D013004:Somatostatin / Q000008:administration & dosage / Q000627:therapeutic use*; D000077585:Terlipressin; D014648:Varicose Veins / Q000150:complications / Q000188:drug therapy; D014662:Vasoconstrictor Agents / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D014662:Vasoconstrictor Agents; D008236:Lypressin; D013004:Somatostatin; D000077585:Terlipressin