Nonselective beta blocker are stand...

Nonselective beta blocker are standard therapy in lowering portal venous compressing to prevent variceal bleeding in patients with cirrhosis and esophageal varices. However, it is not known if the same treatment will stop varices from forming. Groszmann and colleagues waysed a randomized, double-blind, placebo-controlled trial of timolol (Betimol) in patients with cirrhosis and portal hypertension.

They authors listed 213 patients with cirrhosis and elevated portal presss which are defined by a hepatic venous squeezing gradient of 6 mm Hg or greater. in the greatest degree patients were white men. The absence of varices was proven endoscopically. In the research there was an initial dose titration phase during which all patients received timolol, followed by dint of a trial phase in which the patients were randomized to timolol or placebo. Patients were analyzed each three months through physical examination and laboratory assessment and underwent annual endoscopy and measurement of hepatic venous urgency gradient. Median follow-up duration was 55 month The primary expiration point was the development of esophageal varices or variceal bleeding. Secondary [i]finale[/i] points included ascites, encephalopathy, liver transplant, or death.

There was no significant difference in the number of patients reaching the primary period point (42 in the timolol assemblage [39 percent] and 42 in the placebo arrange [40 percent]). The two clumps also were equal in reaching the secondary finis points. Adverse events were more habitual in the group treated with timolol. The authors judge that these findings do not support the use of nonselective beta blocker for preventing esophageal variceal formation in patients with cirrhosis and portal hypertension.

hurl CARTER, M.D.

Groszmann RJ et al. Beta-blockers to intercept gastroesophageal varices in patients with cirrhosis. N Engl J M November 24 2005;353:2254-61

COPYRIGHT 2006 American Academy of Family Physicians

COPYRIGHT 2006 Gale Group