Carvedilol or propranolol in portal hypertension? A randomized comparison
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Carvedilol or propranolol in portal hypertension? A randomized comparison. / Hobolth, Lise; Møller, Søren; Grønbæk, Henning; Roelsgaard, Klaus; Bendtsen, Flemming; Feldager Hansen, Erik; Feldager Hansen, Erik.
I: Scandinavian Journal of Gastroenterology, Bind 47, Nr. 4, 2012, s. 467-74.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Carvedilol or propranolol in portal hypertension?
T2 - A randomized comparison
AU - Hobolth, Lise
AU - Møller, Søren
AU - Grønbæk, Henning
AU - Roelsgaard, Klaus
AU - Bendtsen, Flemming
AU - Feldager Hansen, Erik
AU - Feldager Hansen, Erik
PY - 2012
Y1 - 2012
N2 - Abstract Objectives. Carvedilol is a non-selective ß-blocker with intrinsic anti-a(1)-adrenergic activity, potentially more effective than propranolol in reducing hepatic venous pressure gradient (HVPG). We compared the long-term effect of carvedilol and propranolol on HVPG and assessed whether the acute response to oral propranolol predicted the long-term HVPG response on either drug. Material and methods. HVPG was measured in 38 patients with cirrhosis and HVPG = 12 mm Hg at baseline and then again 90 min after an oral dose of 80 mg propranolol. Patients were double-blinded randomized to either carvedilol (21 patients) or propranolol (17 patients) and after 90 days of treatment HVPG measurements were repeated. Results. HVPG decreased by 19.3 ± 16.1% (p <0.01) and by 12.5 ± 16.7% (p <0.01) in the carvedilol and propranolol groups, respectively, with no significant difference between treatment regimens (p = 0.21). Although insignificant, an acute decrease in HVPG of =12% was the best cut-off value to predict long-term HVPG response to propranolol when using ROC curve analysis. Conclusions. This randomized study showed that carvedilol is at least as effective as propranolol on HVPG after long-term administration. Furthermore, a predictive value of an acute propranolol test on HVPG could not be confirmed.
AB - Abstract Objectives. Carvedilol is a non-selective ß-blocker with intrinsic anti-a(1)-adrenergic activity, potentially more effective than propranolol in reducing hepatic venous pressure gradient (HVPG). We compared the long-term effect of carvedilol and propranolol on HVPG and assessed whether the acute response to oral propranolol predicted the long-term HVPG response on either drug. Material and methods. HVPG was measured in 38 patients with cirrhosis and HVPG = 12 mm Hg at baseline and then again 90 min after an oral dose of 80 mg propranolol. Patients were double-blinded randomized to either carvedilol (21 patients) or propranolol (17 patients) and after 90 days of treatment HVPG measurements were repeated. Results. HVPG decreased by 19.3 ± 16.1% (p <0.01) and by 12.5 ± 16.7% (p <0.01) in the carvedilol and propranolol groups, respectively, with no significant difference between treatment regimens (p = 0.21). Although insignificant, an acute decrease in HVPG of =12% was the best cut-off value to predict long-term HVPG response to propranolol when using ROC curve analysis. Conclusions. This randomized study showed that carvedilol is at least as effective as propranolol on HVPG after long-term administration. Furthermore, a predictive value of an acute propranolol test on HVPG could not be confirmed.
U2 - 10.3109/00365521.2012.666673
DO - 10.3109/00365521.2012.666673
M3 - Journal article
C2 - 22401315
VL - 47
SP - 467
EP - 474
JO - Scandinavian Journal of Gastroenterology
JF - Scandinavian Journal of Gastroenterology
SN - 0036-5521
IS - 4
ER -
ID: 40142785