%0 Journal Article
%T Comparison of drugs facilitating endoscopy for patients with  acute variceal bleeding: a systematic review and network meta-analysis
%A Zou, Ziyuan
%A Yan, Xinwen
%A Lu, Huanpeng
%A Qi, Xingshun
%A Gu, Ye
%A Li, Xun
%A Wu, Bin
%A Qi, Xiaolong
%J Annals of Translational Medicine
%D 2019
%B 2019
%9 
%! Comparison of drugs facilitating endoscopy for patients with  acute variceal bleeding: a systematic review and network meta-analysis
%K 
%X 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.
%U https://atm.amegroups.org/article/view/33261
%V 7
%N 23
%P 717
%@ 2305-5847