@article{ATM33261,
author = {Ziyuan Zou and Xinwen Yan and Huanpeng Lu and Xingshun Qi and Ye Gu and Xun Li and Bin Wu and Xiaolong Qi},
title = {Comparison of drugs facilitating endoscopy for patients with acute variceal bleeding: a systematic review and network meta-analysis},
journal = {Annals of Translational Medicine},
volume = {7},
number = {23},
year = {2019},
keywords = {},
abstract = {Background: We aimed to compare the efficacy of different drugs facilitating endoscopy in patients with acute variceal bleeding.
Methods: Databases were searched to identify randomized controlled trials which compared the efficacy of vasoactive drugs (vasopressin, terlipressin, octreotide, somatostatin) with placebo or each other. The primary outcomes were 6-week and 5-day mortality. Secondary outcomes were 5-day rebleeding, control of initial bleeding and adverse events. Pairwise and network meta-analysis were performed.
Results: We identified 14 RCTs involved 2,187 patients. Four drugs had comparable clinical efficacy in all involving outcomes, except for adverse events. However, we do exhibit a superiority when vasopressin (OR, 4.40; 95% CI: 1.04–19.57), terlipressin (OR, 4.58; 95% CI: 1.63–13.63), octreotide (OR, 5.79; 95% CI: 2.41–16.71) and somatostatin (OR, 5.15; 95% CI: 1.40–27.39) were compared to placebo respectively as for initial hemostasis. In addition, only octreotide was more effective than placebo in decreasing 5-day rebleeding (OR, 0.44; 95% CI: 0.22–0.90). Meanwhile, octreotide was shown to have the highest probability ranking the best to improve initial hemostasis (mean rank =1.8) and carries a lowest risk of adverse events (9.1%) and serious adverse events (0.0%) compared to other drugs.
Conclusions: Balanced with curative effect and tolerability, octreotide may be the preferred vasoactive drug facilitating endoscopy.},
issn = {2305-5847}, url = {https://atm.amegroups.org/article/view/33261}
}