PREVENTION OF REBLEEDING FROM ESOPHAGEAL-VARICES - 2-YEAR FOLLOW-UP OF A PROSPECTIVE CONTROLLED TRIAL OF PROPRANOLOL IN ADDITION TO SCLEROTHERAPY

A prospective randomised trial comparing propranolol and sclerotherapy to sclerotherapy alone was conducted over a 2-year follow up in a dis trict hospital setting of unselected patients. Rebleeding and survival were analysed. Thirty-nine patients were randomised to propranolol pl us sclerotherapy and 34 to sclerotherapy alone. The two groups were cl inically comparable. There was no significant difference in the cumula tive percent of patients free of rebleeding; 54% of the sclerotherapy group rebled compared to 52% of the group treated with propranolol plu s sclerotherapy (Hazard ratio 1.09 (0.54-2.22) and p=0.81, NS). Two-ye ar actuarial survival was also not significantly different, with 77% o f the propanolol plus sclerotherapy group surviving, compared to 74% o f sclerotherapy alone (Hazard ratio 1.08 (0.35-2.22) and p=0.79, NS). The mean time to eradication of varices was not significantly differen t between the two groups (propranolol plus sclerotherapy 222 days, scl erotherapy alone 243 days), nor did the rate of variceal recurrence di ffer (72.7 vs 72 days). This study did not show long-term improvement in rebleeding or survival using propranolol in addition to a regular s clerotherapy programme. (C) Journal of Hepatology.