EFFECT OF LONG-TERM THERAPY WITH NIPRADILOL ON ESOPHAGEAL-VARICES IN PATIENTS WITH COMPENSATED CIRRHOSIS - RESULTS OF A MULTICENTER OPEN STUDY

The effect of long-term administration of nipradilol (NIP, Hypadil Kow a(R), CAS 81486-22-8), a beta-blocker witha vasodilatory action, on es ophageal varices was studied in 66 patients with compensated liver cir rhosis. Administration of NIP (6-12 mg/d) for 3-12 months produced pro gressive improvement of endoscopic findings over time (30% for C, 25% for F, and 40% for the R-C sign after 12 months). At the last examinat ion (mean: 9+/-4 months), the improvement rates were 16.7%, 16.7% and 22.7%, respectively. No significant relationship was found between end oscopic improvement and the Child-Pugh score or the dose of NIP. Gastr ointestinal bleeding occurred in five patients: one had bleeding esoph ageal varices, three had bleed gastric varices, and one had a bleeding gastric ulcer. The systolic blood pressure was decreased significantl y (4.6-12.3%) at 2 weeks as well as 1 and 2 months, and the heart rate showed a significant decrease throughout the study (10-18.4%). With t he exception of the patients who had gastrointestinal bleeding, no sym ptoms of decompensation appeared, and there was not deterioration of l aboratory parameters including ammonia. Adverse effects occurred in ab out 10% of the patients, most of which were related to bradycardia and /or hypotension, and they improved when the drug was withdrawn or the dose reduced. These results suggest that long-term administration of N IP is useful in the treatment of esophageal varices.