Trial reportThe American journal of gastroenterology2016
A Randomized, Multi-Center, Open-Label Study to Evaluate the Efficacy of Carvedilol vs. Propranolol to Reduce Portal Pressure in Patients With Liver Cirrhosis.
Trial report in The American journal of gastroenterology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 5 syntheses or guidelines pooled it, 41 citations in OpenAlex.
- Comparison of Carvedilol to Propranolol in Reduction of Hepatic Venous Pressure Gradient in Liver Cirrhosis: A Meta-Analysis.Journal of gastroenterology and hepatology · 2025Pooled it
- Heterogeneity of treatment response to beta-blockers in the treatment of portal hypertension: A systematic review.Hepatology communications · 2024Pooled it
- Primary prevention of variceal bleeding in people with oesophageal varices due to liver cirrhosis: a network meta-analysis.The Cochrane database of systematic reviews · 2021Pooled it
- KASL clinical practice guidelines for liver cirrhosis: Varices, hepatic encephalopathy, and related complications.Clinical and molecular hepatology · 2020Guideline
- Carvedilol versus traditional, non-selective beta-blockers for adults with cirrhosis and gastroesophageal varices.The Cochrane database of systematic reviews · 2018Pooled it
- Long-Term Outcomes of Carvedilol Plus Endoscopic Variceal Ligation in Secondary Prophylaxis of Variceal Bleeding.Digestive diseases and sciences · 2025Article
- Is carvedilol superior to propranolol in patients with cirrhosis with portal hypertension: a systematic and meta-analysis.Drugs in context · 2025Review
- Ascites affects the benefit of carvedilol on patients with liver cirrhosis and esophageal and gastric varices.Clinical and translational science · 2024Article
- Close Relationship between Systemic Arterial and Portal Venous Pressure in an Animal Model with Healthy Liver.International journal of molecular sciences · 2023Article
- CarvedilolJGH open : an open access journal of gastroenterology and hepatology · 2022Article
- Primary prophylaxis of variceal bleeding in patients with cirrhosis: A comparison of different strategies.World journal of gastrointestinal endoscopy · 2021Review
- β-blockers in advanced cirrhosis: More friend than enemy.Clinical and molecular hepatology · 2021Review
- Diagnosis and clinical management of hepatosplenic schistosomiasis: A scoping review of the literature.PLoS neglected tropical diseases · 2021Article
- The predictive value of baseline hepatic venous pressure gradient for variceal rebleeding in cirrhotic patients receiving secondary prevention.Annals of translational medicine · 2020Article
- [The application of non-selective β-blockers, angiotensin receptor antagonists and statins in liver cirrhotic patients].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2019Review
- Dose-dependent effect of propranolol on the hemodynamic response in cirrhotic patients with gastroesophageal varices.European journal of gastroenterology & hepatology · 2019Article
- Impact of an acute hemodynamic response-guided protocol for primary prophylaxis of variceal bleeding.World journal of clinical cases · 2018Article
- Beneficial and harmful effects of nonselective beta blockade on acute kidney injury in liver transplant candidates.Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society · 2017Article
- Secondary prophylaxis for variceal bleeding: carvedilol vs. propranolol.Hepatology international · 2017Article
- Long-term Outcomes with Carvedilol versus Propranolol in Patients with Index Variceal Bleed: 6-year Follow-up Study.Journal of clinical and experimental hepatologyArticle
Corrections and comments
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Authors and funding
13 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesPropranolol has been used as prophylaxis for variceal bleeding in patients with cirrhosis. More recent data suggest that carvedilol may be more effective for reducing the hepatic venous pressure gradient (HVPG) than propranolol. The primary aim of this study was to evaluate the hemodynamic response to carvedilol compared with propranolol.
methodsA total of 110 patients with a baseline HVPG value >12 mm Hg were allocated randomly to receive either carvedilol or propranolol. The HVPG measurement was repeated after 6 weeks of daily medication. The primary end point was a ≥20% fall in HVPG compared with baseline or <12 mm Hg.
resultsThe difference in the proportion of responders in the carvedilol (49.1%) vs. propranolol (30.9%) groups did not reach statistical significance in the intention-to-treat analysis (P=0.08). However, among patients with a model for end-stage liver disease (MELD) score ≥15, carvedilol resulted in a significantly greater response than that of propranolol (7/12, 58.3% vs. 0/10, 0%; P=0.005). Similarly, carvedilol was superior to propranolol in patients with Child-Pugh score ≥9 (46.2 vs. 0%; P=0.046). The presence of ascites also had a significant influence on the response rate (51.5 vs. 24.2%; P=0.042). A MELD score ≥15 was the only significant predictor of response among these post hoc groups after adjusting for multiple comparisons (P=0.005). Severe adverse events were higher in the carvedilol group although drug-associated adverse events were not different.
conclusionsOverall, carvedilol offered no clear advantage over propranolol but it may be more effective in advanced cirrhotic patients with a MELD score≥15 in reducing the portal pressure gradient. However, this potential benefit may come with a cost of increased risk of side-effects and outcome data over a longer term is needed to understand the relative risk benefit.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.