A Prospective Study Comparing the Efficacy of Early Administration of Terlipressin and Somatostatin for the Control of Acute Variceal Bleeding in Patients with Cirrhosis.
- Author:
Yeon Seok SEO
1
;
Soon Ho UM
;
Jong Jin HYUN
;
Youn Ho KIM
;
Sanghoon PARK
;
Bo Ra KEUM
;
Yong Sik KIM
;
Yoon Tae JEEN
;
Hong Sik LEE
;
Hoon Jai CHUN
;
Sang Woo LEE
;
Jai Hyun CHOI
;
Chang Duck KIM
;
Ho Sang RYU
Author Information
1. Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea. umsh@korea.ac.kr
- Publication Type:Original Article ; English Abstract ; Randomized Controlled Trial
- Keywords:
Liver cirrhosis;
Variceal bleeding;
Hemostasis;
Terlipressin;
Somatostatin
- MeSH:
Acute Disease;
Aged;
Carcinoma, Hepatocellular/complications;
Esophageal and Gastric Varices/complications/*drug therapy;
Female;
Gastrointestinal Hemorrhage/complications/*drug therapy;
Hemorrhage/complications/drug therapy;
Hemostasis, Endoscopic;
Humans;
Liver/*blood supply;
Liver Cirrhosis/*complications;
Liver Diseases/drug therapy;
Liver Neoplasms/complications;
Lysine Vasopressin/administration & dosage/*analogs & derivatives/therapeutic use;
Male;
Middle Aged;
Multivariate Analysis;
Somatostatin/administration & dosage/*therapeutic use;
Varicose Veins/complications/drug therapy;
Vasoconstrictor Agents/administration & dosage/*therapeutic use
- From:The Korean Journal of Hepatology
2006;12(3):373-384
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: 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.
