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Clinical trial: the effect of somatostatin vs. octreotide in preventing post‐endoscopic increase in hepatic venous pressure gradient in cirrhotics with bleeding varices
Author(s) -
VLACHOGIANNAKOS J.,
KOUGIOUMTZIAN A.,
TRIANTOS C.,
VIAZIS N.,
SGOUROS S.,
MANOLAKOPOULOS S.,
SAVERIADIS A.,
MARKOGLOU C.,
ECONOMOPOULOS T.,
KARAMANOLIS D. G.
Publication year - 2007
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2007.03539.x
Subject(s) - octreotide , medicine , somatostatin , portal venous pressure , varices , gastroenterology , portal hypertension , endoscopy , randomized controlled trial , cirrhosis
Summary Background Hepatic venous pressure gradient (HVPG) increases significantly after endoscopic therapy in patients with bleeding oesophageal varices, which may precipitate further haemorrhage. Whether vasoactive drugs can suppress these changes remains unknown. Aim To investigate the efficacy of somatostatin when compared with octreotide in preventing the post‐endoscopic increase in HVPG during acute bleeding and whether the changes affect outcome. Methods Thirty‐three cirrhotics with bleeding varices were randomized to receive somatostatin ( n  = 17) or octreotide ( n  = 16) under double‐blind conditions, soon after their admission. HVPG measurements were performed before and immediately after endoscopic treatment. Results In the somatostatin group, postendotherapy HVPG values did not change significantly when compared with pre‐treatment values (18.9 vs. 17.2, P  = 0.092). Conversely, in the octreotide group, HVPG increased significantly after endoscopy (18.2 vs. 20.8, P  = 0.003). The probability of 6‐week survival without treatment failure was significantly higher in the somatostatin group ( P  = 0.024). Post‐endoscopic HVPG value was independently associated with 6‐week failure. Conclusions Somatostatin, but not octreotide, effectively prevents the post‐endoscopic increase in HVPG, which may be associated with low probability of treatment failure.

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