Banding Ligation With Carvedilol Versus Carvedilol for the Prevention of First Bleeding

E-DA Hospital

Status and phase: Terminated; Phase 4

Conditions: Variceal Bleeding

Treatments: Drug: carvedilol; Procedure: EVL + carvedilol

Study type: Interventional

Funder types: Other

Identifiers

NCT01383044

Carvedilol

Details and patient eligibility

About

Endoscopic variceal ligation (EVL) and carvedilol have been documented to be effective in prophylaxis of the first bleeding. The efficacy & safety of combining EVL and carvedilol in prophylaxis of the first bleeding is still unknown. This study aims to investigate the value of combination therapy.

Full description

Combination of EVL and β-blocker has been proven effective in the prevention of variceal rebleeding . However, Our previous study showed that combination of EVL and nadolol do not have enhanced effect in the prophylaxis of 1st variceal bleeding as compared with nadolol alone . One of the drawbacks of EVL is esophageal ulcer. On the other hand ,carvedilol, an anti-α beta-blocker, has been proven to be more effective than propranolol in the reduction of portal pressure. Carvedilol has been proven to be more effective than EVL in the prevention of 1st variceal bleeding. The investigators thus conduct a multicenter trial to evaluate whether combination of EVL and carvedilol could be more effective than carvedilol alone in the prophylaxis of 1st esophageal variceal bleeding . The goal of patients receiving EVL is to reduce variceal size, not variceal obliteration, in anticipation for fewer sessions required for each patient and fewer possibility of esophageal ulcer bleeding.

Enrollment: 65 patients

Sex: All

Ages: 20 to 75 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Cirrhosis with esophageal varices are larger than F2.
2. No history of variceal bleeding.
3. In three months have not implemented preventive esophageal variceal ligation. (4)age 20yrs～75yrs.

Exclusion criteria

1. Association with HCC or other cancers .
2. Refractory ascites.
3. Jaundice, bilirubin > 5mg/dl.
4. Encephalopathy.
5. Cr.>3mg/dL.
6. A-V,block bradycardia (PR < 60/mim).
7. Hypotension systolic blood pressure<95/mmHg .
8. Refusal to participate.
9. Carvedilol allergy
10. Second degree-third degree Atrio-ventricular block.
11. Bradycardia.
12. WPWsyndrome
13. Hypotension
14. Psychogenic shock.
15. Asthma. All the patients are randomized based on a random number.

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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65 participants in 2 patient groups

EVL + carvedilol

Experimental group

Description:

EVL is performed for 2-3 times carvedilol 6.25mg-12.5 mg per day

Treatment:

Procedure: EVL + carvedilol

carvedilol

Active Comparator group

Description:

carvedilol 6.25-12.5 mg per day

Treatment:

Drug: carvedilol