title: [Comparison of terlipressin and octreotide with variceal ligation for controlling acute esophageal variceal bleeding--a randomized prospective study].
abstract: OBJECTIVE
  Terlipressin and octreotide had been used to control acute variceal bleeding and to prevent early rebleeding after endoscopic hemostasis. We compared the efficacy and safety of terlipressin and octreotide combined with endoscopic variceal ligation (EVL) for the treatment of acute esophageal variceal bleeding and we evaluated their clinical significance as related to rebleeding.
  
  
  METHODS
  The eighty eight cirrhotic patients were randomized to the terlipressin group (n=43; 2 mg i.v. initially and 1 mg i.v. at every 4 hours for 3 days) or the octreotide group (n=45; continuous infusion of 25 microgram/h for 5 days) combined with EVL for the treatment of acute esophageal variceal bleeding.
  
  
  RESULTS
  The initial hemostasis rates were 98% (42/43 cases) in the terlipressin group and 96% (43/45 cases) in the octreotide group. The 5-day and 42-day rebleeding rates were 12% (5/43 cases) and 28% (12/43 cases), respectively, in the terlipressin group and 9% (4/45 cases) and 24% (11/45 cases), respectively, in the octreotide group. No significant difference was demonstrated between the terlipressin and octreotide groups. The mortality at 42 days was similar in both group, but a high mortality rate (48%) was shown to be related to 42-day rebleeding. The risk factors related to 42-day rebleeding were Child-Pugh class C (aOR=30.2, 95% CI=7.7-117.9), ascites above grade II (aOR=6.6, 95% CI=2.2-19.2) and advanced hepatocellular carcinoma (aOR=4.6, 95% CI=1.1-18.9).
  
  
  CONCLUSIONS
  Comparing terlipressin and octreotide combined with EVL showed them to be equally safe and effective therapeutic agents in patients with acute esophageal variceal bleeding. The high risk factors related to early rebleeding were poor liver function and advanced hepatocellular carcinoma.
authors.affiliation: Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Sung Bum
authors.initials: SB
authors.lastname: Cho
authors.forename: Kang Jin
authors.initials: KJ
authors.lastname: Park
authors.forename: Jung Soo
authors.initials: JS
authors.lastname: Lee
authors.forename: Wan Sik
authors.initials: WS
authors.lastname: Lee
authors.forename: Chang Hwan
authors.initials: CH
authors.lastname: Park
authors.forename: Young Eun
authors.initials: YE
authors.lastname: Joo
authors.forename: Hyun Soo
authors.initials: HS
authors.lastname: Kim
authors.forename: Sung Kyu
authors.initials: SK
authors.lastname: Choi
authors.forename: Jong Sun
authors.initials: JS
authors.lastname: Rew
authors.forename: Sei Jong
authors.initials: SJ
authors.lastname: Kim
mesh_terms: D000208:Acute Disease; D000368:Aged; D004932:Esophageal and Gastric Varices / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D006801:Humans; D008103:Liver Cirrhosis / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D008236:Lypressin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use*; D000077585:Terlipressin; D014662:Vasoconstrictor Agents / Q000627:therapeutic use*
chemical_list: D014662:Vasoconstrictor Agents; D008236:Lypressin; D000077585:Terlipressin; D015282:Octreotide