Evidence map›Paper›PMID 40968192›Full record

SynthesisHepatology international2025

Propranolol versus endoscopic variceal ligation for primary prophylaxis of esophageal varices in cirrhosis: a systematic review and meta-analysis of randomized controlled trials.

Leonardo Corrêa Süffert, Luis Pedro Possapp Beis, Isabella Heringer Padilha, Henrique Steffens de Abreu, Jesuély Spieckert de Souza, Victor Alves Galvão, Frederico Friedrich, Marcelo Campos Appel da Silva

Abstract readSystematic ReviewMeta-AnalysisComparative Study
PubMed Publisher
In one paragraph

Synthesis in Hepatology international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Preventing First and Further Decompensation in Advanced Chronic Liver Disease.Liver international : official journal of the International Association for the Study of the Liver · 2026
    Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Leonardo Corrêa SüffertSchool of Medicine, Pontifical Catholic University of Rio Grande do Sul, 6681 Ipiranga Av, Partenon, Porto Alegre, RS, 90619-900, Brazil. leo.correasuffert@gmail.com.ORCID http://orcid.org/0009-0009-7210-6713
Luis Pedro Possapp BeisSchool of Medicine, Pontifical Catholic University of Rio Grande do Sul, 6681 Ipiranga Av, Partenon, Porto Alegre, RS, 90619-900, Brazil.
Isabella Heringer PadilhaSchool of Medicine, Pontifical Catholic University of Rio Grande do Sul, 6681 Ipiranga Av, Partenon, Porto Alegre, RS, 90619-900, Brazil.
Henrique Steffens de AbreuSchool of Medicine, Pontifical Catholic University of Rio Grande do Sul, 6681 Ipiranga Av, Partenon, Porto Alegre, RS, 90619-900, Brazil.
Jesuély Spieckert de SouzaSchool of Medicine, Pontifical Catholic University of Rio Grande do Sul, 6681 Ipiranga Av, Partenon, Porto Alegre, RS, 90619-900, Brazil.
Victor Alves GalvãoGastrointestinal Bleeding Center, Hospital Geral Clériston Andrade, Feira de Santana, Brazil.
Frederico FriedrichSchool of Medicine, Pontifical Catholic University of Rio Grande do Sul, 6681 Ipiranga Av, Partenon, Porto Alegre, RS, 90619-900, Brazil.
Marcelo Campos Appel da SilvaDepartment of Gastroenterology, Hospital Mãe de Deus, Porto Alegre, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSeveral studies have shown similar efficacy between nonselective beta-blockers (NSBBs) and endoscopic variceal ligation (EVL) in preventing esophageal variceal bleeding in cirrhosis. However, the comparative effectiveness between propranolol (PPL) and EVL remains uncertain. This meta-analysis evaluated both strategies.

methodsPubMed, Embase, and Cochrane Central were searched for randomized-controlled trials (RCTs) comparing PPL and EVL for primary prophylaxis of esophageal variceal bleeding in cirrhotic patients. Outcomes were evaluated using risk ratios (RR) with 95% confidence intervals (CI), and heterogeneity was assessed by the I

resultsFourteen RCTs were included, comprising 1345 patients: 664 (49.4%) received EVL and 681 (50.6%) PPL. EVL was more effective in preventing esophageal variceal hemorrhage (RR: 1.40; 95% CI: 1.02-1.91; p = 0.035; I

conclusionEVL was superior in preventing esophageal variceal bleeding. Such results suggest that not all NSBBs provide equivalent efficacy in primary prophylaxis, reinforcing the need for further studies to confirm these findings.

Indexed as

Adrenergic beta-AntagonistsEsophageal and Gastric VaricesGastrointestinal HemorrhageLiver CirrhosisPropranololHumansLigationPrimary PreventionRandomized Controlled Trials as TopicTreatment OutcomeAdrenergic beta-AntagonistsPropranololAdverse eventsAscitesChild–Pugh classificationChronic liver diseaseEndoscopic band ligationLiver fibrosisNon-selective beta blockersPortal hypertensionPrimary preventionVariceal hemorrhage

Identifiers

PMID40968192

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.