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Evidence summaries

Beta-Blockers in the Prevention of Gastrointestinal Rebleeding in Patients with Cirrhosis

Noncardioselective beta-blockers reduce rebleeding rate from any cause and from oesophageal varices, and significantly increase long-term survival in patients with cirrhosis and previous bleeding. Level of evidence: "A"

A systematic review 1 including 12 RCTs with a total of 769 subjects was abstracted in DARE. Beta blockers significantly increased the mean percentage of patient free of rebleeding with a 21% mean improvement rate (95% CI 10% to 32%, p<0.001) with a relative risk of rebleeding among patients not receiving treatment 1.42. NNT to prevent one rebleeding was 5.

Use of beta blockers compared to control significantly improved survival, with a mean improvement rate of 5.4% (95% CI 0% to 11%, p=0.05). The relative risk of death among untreated patients was 1.27. NNT to prevent one death was 14.

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Primary/Secondary Keywords