Efficacy of octreotide and sclerotherapy in the treatment of acute variceal bleeding in cirrhotic patients - A prospective, multicentric, and randomized clinical trial

Background: Sclerotherapy is the most widely used method for treatment of a cute variceal bleeding. Previous reports have suggested that octreotide inf usion is as effective as sclerotherapy. Our aim was to investigate the effi cacy and safety of octreotide in comparison with sclerotherapy in controlli ng variceal bleeding. Methods: Seventy-six cirrhotic patients were randomiz ed to receive either sclerotherapy (n = 37) or octreotide (n = 39) infusion of 50 mu g/h intravenously for 48 h after a bolus of 100 mu g, followed by subcutaneous injection of 100 mu g/8 h for an additional 72 h. Results: Th e two groups were similar in base-line data. A similar initial control of b leeding was obtained in 94.6% for sclerotherapy and 84.6% for octreotide (N S). No difference was observed between sclerotherapy and octreotide in rebl eeding (23% versus 33%) and treatment failure (22% versus 36%, respectively ). Furthermore, the overall success of treatment was 78% for sclerotherapy and 64% for octreotide. No significant difference in mortality was observed between treatments (eight patients for octreotide and three patients for s clerotherapy, NS). Conclusions: These results show that both treatments pre sent a very high and similar initial and final control of bleeding. However , there is a trend that could be clinically important towards better result s in the patients treated with sclerotherapy.