Short-term vasoactive agent treatment driven by physicians’ preference in acute esophageal variceal bleeding in a tertiary center
Background Vasoactive drugs are frequently used in combination with endoscopic variceal ligation (EVL) in treatment of acute esophageal variceal bleeding (EVB). The aim of study was to assess physicians’ preference of vasoactive agents in acute EVB, their reasons of preference and efficacy and safet...
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PeerJ Inc.
2019-11-01
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| Online Access: | https://peerj.com/articles/7913.pdf |
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| author | Yoen Young Chuah Ping-I Hsu Wei-Lun Tsai Hsien-Chung Yu Feng-Woei Tsay Wen-Chi Chen Kung Hung Lin Yeong Yeh Lee Huay-Min Wang |
| author_facet | Yoen Young Chuah Ping-I Hsu Wei-Lun Tsai Hsien-Chung Yu Feng-Woei Tsay Wen-Chi Chen Kung Hung Lin Yeong Yeh Lee Huay-Min Wang |
| author_sort | Yoen Young Chuah |
| collection | DOAJ |
| description | Background Vasoactive drugs are frequently used in combination with endoscopic variceal ligation (EVL) in treatment of acute esophageal variceal bleeding (EVB). The aim of study was to assess physicians’ preference of vasoactive agents in acute EVB, their reasons of preference and efficacy and safety of these short course regimens. Methods Cirrhotic patients with suspected EVB were screened (n = 352). Eligible patients were assigned based on the physician’s preference to either somatostatin (group S) or terlipressin (group T) followed by EVL. In group S, intravenous bolus (250 µg) of somatostatin followed by 250 µg/hour was continued for three days. In group T, 2 mg bolus injection of terlipressin was followed by 1 mg infusion every 6 h for three days. Results A total of 150 patients were enrolled; 41 in group S and 109 in group T. Reasons for physician preference was convenience in administration (77.1%) for group T and good safety profile (73.2%) for group S. Very early rebleeding within 49–120 h occurred in one patient in groups S and T (p = 0.469). Four patients in group S and 14 patients in group T have variceal rebleeding episodes within 6–42 d (p = 0.781). Overall treatment-related adverse effects were compatible in groups S and T (p = 0.878), but the total cost of terlipressin and somatostatin differed i.e., USD 621.32 and USD 496.43 respectively. Conclusions Terlipressin is the preferred vasoactive agent by physicians in our institution for acute EVB. Convenience in administration and safety profile are main considerations of physicians. Safety and hemostatic effects did not differ significantly between short-course somatostatin or terlipressin, although terlipressin is more expensive. |
| first_indexed | 2024-03-09T06:45:03Z |
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| issn | 2167-8359 |
| language | English |
| last_indexed | 2024-03-09T06:45:03Z |
| publishDate | 2019-11-01 |
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| spelling | doaj.art-2595837fa7b44f6fb37a801fab2a5cb52023-12-03T10:36:29ZengPeerJ Inc.PeerJ2167-83592019-11-017e791310.7717/peerj.7913Short-term vasoactive agent treatment driven by physicians’ preference in acute esophageal variceal bleeding in a tertiary centerYoen Young Chuah0Ping-I Hsu1Wei-Lun Tsai2Hsien-Chung Yu3Feng-Woei Tsay4Wen-Chi Chen5Kung Hung Lin6Yeong Yeh Lee7Huay-Min Wang8Division of Gastroenterology and Hepatology, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; School of Medicine, National Yang-Ming University, Taipei, TaiwanDivision of Gastroenterology and Hepatology, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; School of Medicine, National Yang-Ming University, Taipei, TaiwanDivision of Gastroenterology and Hepatology, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; School of Medicine, National Yang-Ming University, Taipei, TaiwanDivision of Gastroenterology and Hepatology, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; School of Medicine, National Yang-Ming University, Taipei, TaiwanDivision of Gastroenterology and Hepatology, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; School of Medicine, National Yang-Ming University, Taipei, TaiwanDivision of Gastroenterology and Hepatology, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; School of Medicine, National Yang-Ming University, Taipei, TaiwanDivision of Gastroenterology and Hepatology, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; School of Medicine, National Yang-Ming University, Taipei, TaiwanSchool of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, MalaysiaDivision of Gastroenterology and Hepatology, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; School of Medicine, National Yang-Ming University, Taipei, TaiwanBackground Vasoactive drugs are frequently used in combination with endoscopic variceal ligation (EVL) in treatment of acute esophageal variceal bleeding (EVB). The aim of study was to assess physicians’ preference of vasoactive agents in acute EVB, their reasons of preference and efficacy and safety of these short course regimens. Methods Cirrhotic patients with suspected EVB were screened (n = 352). Eligible patients were assigned based on the physician’s preference to either somatostatin (group S) or terlipressin (group T) followed by EVL. In group S, intravenous bolus (250 µg) of somatostatin followed by 250 µg/hour was continued for three days. In group T, 2 mg bolus injection of terlipressin was followed by 1 mg infusion every 6 h for three days. Results A total of 150 patients were enrolled; 41 in group S and 109 in group T. Reasons for physician preference was convenience in administration (77.1%) for group T and good safety profile (73.2%) for group S. Very early rebleeding within 49–120 h occurred in one patient in groups S and T (p = 0.469). Four patients in group S and 14 patients in group T have variceal rebleeding episodes within 6–42 d (p = 0.781). Overall treatment-related adverse effects were compatible in groups S and T (p = 0.878), but the total cost of terlipressin and somatostatin differed i.e., USD 621.32 and USD 496.43 respectively. Conclusions Terlipressin is the preferred vasoactive agent by physicians in our institution for acute EVB. Convenience in administration and safety profile are main considerations of physicians. Safety and hemostatic effects did not differ significantly between short-course somatostatin or terlipressin, although terlipressin is more expensive.https://peerj.com/articles/7913.pdfTerlipressinSomatostatinEsophageal variceal bleedingPhysician preference |
| spellingShingle | Yoen Young Chuah Ping-I Hsu Wei-Lun Tsai Hsien-Chung Yu Feng-Woei Tsay Wen-Chi Chen Kung Hung Lin Yeong Yeh Lee Huay-Min Wang Short-term vasoactive agent treatment driven by physicians’ preference in acute esophageal variceal bleeding in a tertiary center PeerJ Terlipressin Somatostatin Esophageal variceal bleeding Physician preference |
| title | Short-term vasoactive agent treatment driven by physicians’ preference in acute esophageal variceal bleeding in a tertiary center |
| title_full | Short-term vasoactive agent treatment driven by physicians’ preference in acute esophageal variceal bleeding in a tertiary center |
| title_fullStr | Short-term vasoactive agent treatment driven by physicians’ preference in acute esophageal variceal bleeding in a tertiary center |
| title_full_unstemmed | Short-term vasoactive agent treatment driven by physicians’ preference in acute esophageal variceal bleeding in a tertiary center |
| title_short | Short-term vasoactive agent treatment driven by physicians’ preference in acute esophageal variceal bleeding in a tertiary center |
| title_sort | short term vasoactive agent treatment driven by physicians preference in acute esophageal variceal bleeding in a tertiary center |
| topic | Terlipressin Somatostatin Esophageal variceal bleeding Physician preference |
| url | https://peerj.com/articles/7913.pdf |
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