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A randomized phase IV clinical trial comparing Nadolol and Isosorbide Mononitrate (ISMN) with the combination of Endoscopic Banding Ligation plus Nadolol and ISMN in the prevention of variceal rebleeding

Not Applicable
Completed
Conditions
Variceal bleeding
Circulatory System
Registration Number
ISRCTN26221020
Lead Sponsor
Individual Sponsor (Spain)
Brief Summary

2009 Results article in http://www.ncbi.nlm.nih.gov/pubmed/19218249 pub

Detailed Description

Not available

Recruitment & Eligibility

Status
Completed
Sex
All
Target Recruitment
160
Inclusion Criteria

1. Age between 18-75
2. Diagnosis of cirrhosis
3. Hematemesis or melena within 7 days prior to inclusion
4. Esophageal or gastroesophageal varices as the source of bleeding
5. Written informed consent
6. Exclusion of pregnancy in woman of child-bearing potential

Exclusion Criteria

1. Hepatocellular carcinoma >5 cm or multinodular
2.Creatinine >2 mg/dl
3. Child-Pugh =13 points
4. Contraindications to beta-adrenergic blockers
5. Contraindications to ISMN
6. Banding ligation in the 3 months before the present episode of variceal bleeding
7. Previous portosystemic derivative therapy
8. Bleeding from fundal or ectopic varices
9. Total portal vein thrombosis or portal vein cavernomatosis
10. The patient was already on beta-adrenergic blockers and ISMN for the prevention of variceal bleeding

Study & Design

Study Type
Interventional
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Rebleeding from any source
Secondary Outcome Measures
NameTimeMethod
<br> 1. Rebleeding from esophageal varices<br> 2. Rebleeding from other portal hypertensive sources<br> 3. Death<br> 4. Death from variceal bleeding<br> 5. Death from rebleeding<br> 6. Frequency of severe adverse events<br> 7. Relation between changes in hepatic venous pressure gradient and clinical events<br> 8. Development of any complication of portal hypertension or death<br> 9. Changes in variceal size<br> 10. Transfusion requirements<br> 11. Requirement for alternative therapies<br> 12. Costs<br>
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