Scholarlink

Background <p>This two-stage individual patient data meta-analysis (IPD-MA) compared the efficacy of a shorter duration (≤ 2&#xa0;days) of vasoactive (VA) drug therapy to standard duration (3–5&#xa0;days) after acute variceal bleeding (AVB) in patients with liver cirrhosis.</p> Patients and Methods <p>Randomized clinical trials on patients with cirrhosis and AVB undergoing endoscopic band ligation which compared a short duration versus the standard duration of VA therapy were included. The primary outcome was 5-day rebleeding rate. Secondary outcomes included 5-day and 42-day mortality, 42-day rebleeding rate, and length of hospital stay in patients receiving short duration of therapy as compared to those receiving standard duration. Aggregate data meta-analysis and IPD-MA of trials were performed for these outcomes and comparisons in patients with different severities of liver disease.</p> Results <p>Out of 11 eligible trials, 542 IPD data sets were available from 6 trials. Two hundred and seventy-nine patients received short duration and 263 received standard duration VA therapy. Two-stage IPD-MA revealed no significant differences in the 5-day rebleeding rate (HR = 0.59, 95%CI: 0.19–1.81, <i>p</i> = 0.66), 5-day mortality (HR = 1.12, 95%CI: 0.18–6.63, <i>p</i> = 0.44), 42-day rebleeding rate (HR = 0.95, 95%CI: 0.47–1.90, <i>p</i> = 0.90) and 42-day mortality (HR = 1.05, 95% CI: 0.43–2.56, <i>p</i> = 0.34) between the two groups. One-stage IPD-MA revealed no significant differences in the outcomes across Child–Pugh classes, with shorter hospital stay in short duration group.</p> Conclusions <p>Short duration VA therapy has similar outcomes to standard duration in patients with liver cirrhosis presenting with AVB, irrespective of severity of liver disease.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Abbreviated Duration of Vasoactive Agents Has Similar Outcomes as Standard Duration of Therapy in Patients with Liver Cirrhosis and Variceal Bleeding: An Individual Patient Data Meta-Analysis

  • 期刊论文

  • 发表日期：

    2025年1月27日

查看全文
  • Sagnik Biswas,
  • Gin-Ho Lo,
  • Shubham Mehta,
  • Anshuman Elhence,
  • Yu Jun Wong,
  • Manas Vaishnav,
  • Umang Arora,
  • Vignesh Dwarakanathan,
  • Shekhar Swaroop,
  • Arnav Aggarwal,
  • Ayush Agarwal,
  • Pranjal Singh,
  • Amitkumar Chavan,
  • Shashank Tripathi,
  • Deba Prasad Dhibar,
  • Sheik Manwar Ali,
  • Vishal Sharma,
  • Ashish Kumar,
  • Samagra Agarwal,
  • Shalimar

摘要

Background

This two-stage individual patient data meta-analysis (IPD-MA) compared the efficacy of a shorter duration (≤ 2 days) of vasoactive (VA) drug therapy to standard duration (3–5 days) after acute variceal bleeding (AVB) in patients with liver cirrhosis.

Patients and Methods

Randomized clinical trials on patients with cirrhosis and AVB undergoing endoscopic band ligation which compared a short duration versus the standard duration of VA therapy were included. The primary outcome was 5-day rebleeding rate. Secondary outcomes included 5-day and 42-day mortality, 42-day rebleeding rate, and length of hospital stay in patients receiving short duration of therapy as compared to those receiving standard duration. Aggregate data meta-analysis and IPD-MA of trials were performed for these outcomes and comparisons in patients with different severities of liver disease.

Results

Out of 11 eligible trials, 542 IPD data sets were available from 6 trials. Two hundred and seventy-nine patients received short duration and 263 received standard duration VA therapy. Two-stage IPD-MA revealed no significant differences in the 5-day rebleeding rate (HR = 0.59, 95%CI: 0.19–1.81, p = 0.66), 5-day mortality (HR = 1.12, 95%CI: 0.18–6.63, p = 0.44), 42-day rebleeding rate (HR = 0.95, 95%CI: 0.47–1.90, p = 0.90) and 42-day mortality (HR = 1.05, 95% CI: 0.43–2.56, p = 0.34) between the two groups. One-stage IPD-MA revealed no significant differences in the outcomes across Child–Pugh classes, with shorter hospital stay in short duration group.

Conclusions

Short duration VA therapy has similar outcomes to standard duration in patients with liver cirrhosis presenting with AVB, irrespective of severity of liver disease.