Beta Blockers Versus Variceal Band Ligation and Beta Blockers for Primary Prophylaxis of Variceal Bleeding
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Purpose
Patients with scarring of the liver (cirrhosis) and portal hypertension (elevated blood pressure in the liver vasculature) can develop esophageal varices (dilated veins). These have an increased risk of bleeding each year. Current recommendations are to prevent bleeding of medium or large varices (when there is no history of bleeding) by starting a blood pressure lowering agent known as a non-selective beta-blocker. Alternatively, rubber bands can be placed on medium to large varices to prevent bleeding (endoscopic variceal band ligation). Using both therapies at the same time has not been studied. In this study, we hope to determine if the use of combination therapy with endoscopic variceal band ligation and beta blockers is more effective than using beta blockers alone to prevent the first bleeding episode from the varices (dilated veins). The efficacy, ability to tolerate, and cost-effectiveness of these two treatment strategies will be compared.
| Condition | Intervention | Phase |
|---|---|---|
|
Esophageal Varices |
Procedure: endoscopic variceal band ligation |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Prevention |
| Official Title: | Beta Blockers Versus Variceal Band Ligation and Beta Blockers for Primary Prophylaxis of Variceal Bleeding |
- first variceal bleed [ Time Frame: 2 years ] [ Designated as safety issue: No ]
- survival [ Time Frame: 2 years ] [ Designated as safety issue: No ]
- liver function [ Time Frame: 1 year ] [ Designated as safety issue: No ]
- encephalopathy [ Time Frame: 1 year ] [ Designated as safety issue: No ]
- quality of life [ Time Frame: 1 year ] [ Designated as safety issue: No ]
- frequency of other complications of cirrhosis [ Time Frame: 2 years ] [ Designated as safety issue: No ]
- cost utility [ Time Frame: 1 year ] [ Designated as safety issue: No ]
- patient preference [ Time Frame: 1 year ] [ Designated as safety issue: No ]
| Enrollment: | 2 |
| Study Start Date: | December 2006 |
| Study Completion Date: | June 2009 |
| Primary Completion Date: | June 2009 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: 1
endoscopic variceal band ligation
|
Procedure: endoscopic variceal band ligation
endoscopic variceal band ligation
|
|
Active Comparator: 2
subjects will receive nadolol (beta blocker) at 20mg/day with dose titration
|
Procedure: endoscopic variceal band ligation
endoscopic variceal band ligation
|
Eligibility| Ages Eligible for Study: | 18 Years to 75 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- cirrhosis
- medium to large varices
Exclusion Criteria:
- contraindications to beta blockers
- refusal to give consent
- prior history of variceal hemorrhage
- creatinine > 1.5 mg/dl
Contacts and Locations| United States, Virginia | |
| Virginia Commonwealth University | |
| Richmond, Virginia, United States, 23298 | |
| Principal Investigator: | Arun J Sanyal, M.D. | Division of Gastroenterology, Virginia Commonwealth University |
More Information
No publications provided
| Responsible Party: | Arun J. Sanyal, MD, Virginia Commonwealth University |
| ClinicalTrials.gov Identifier: | NCT00409084 History of Changes |
| Other Study ID Numbers: | HM10546 |
| Study First Received: | December 6, 2006 |
| Last Updated: | July 2, 2010 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Virginia Commonwealth University:
|
varices band ligation portal hypertension |
primary prophylaxis cirrhosis beta blockers |
Additional relevant MeSH terms:
|
Esophageal Diseases Esophageal and Gastric Varices Hemorrhage Varicose Veins Gastrointestinal Diseases Digestive System Diseases Hypertension, Portal Liver Diseases Pathologic Processes |
Vascular Diseases Cardiovascular Diseases Adrenergic beta-Antagonists Adrenergic Antagonists Adrenergic Agents Neurotransmitter Agents Molecular Mechanisms of Pharmacological Action Pharmacologic Actions Physiological Effects of Drugs |
ClinicalTrials.gov processed this record on May 22, 2013