A Phase 4 interventional study of terlipressin (vasoconstrictor) and pantoloc (proton pump inhibitor) in Esophageal Variceal Rebleeding, sponsored by National Science Council, Taiwan. Status unknown. Open to participants aged 18 Years to 80 Years. Per ClinicalTrials.gov, last updated 2009-03-18.
Sponsored by National Science Council, Taiwan · Phase 4, Interventional, and Treatment
BACKGROUND: Previous studies showed that the combination of endoscopic therapy with vasoconstrictor is better than either vasoconstrictor or endoscopic therapy alone in achieving the successful hemostatsis of acute variceal bleeding. The rationale of using vasoconstrictor is to enhance the efficacy of hemostasis by endoscopic therapy. Nowadays, endoscopic variceal ligation (EVL) has replaced endoscopic injection sclerotherapy (EIS) as the endoscopic treatment of choice in the arresting of acute esophageal variceal hemorrhage. EVL alone can achieve hemotasis up to 97% even in cases of active variceal hemorrhage. However, early rebleeding due to ligation-induced ulcer may be encountered. It appears that prevention of esophageal ulcers and bleeding by a proton pump inhibitor may be more logical than using a vasoconstrictor after cessation of bleeding by EVL.
Thus, the investigators designed a controlled trial to compare the initial hemostasis, early rebleeding rate in cirrhotic patients presenting with acute variceal bleeding receiving either emergency EVL plus vasoconstrictor infusion or losec infusion for 5 days.
Methods of treatment:
Group 1: Somatostatin 250μg slow bolus IV infusion followed by 250μg per hour (6mg/ 24 hours) or Terlipressin 2mg bolus was instituted on enrollment followed by 1mg per 6 hours for 5 days. The use of either somatostatin or glypressin was at the discretion of doctors in charge. Group 2: Pantoloc 20 mg intravenously per day was instituted on enrollment and continued for 5 days.
Definition of initial hemostasis:
Initial hemostasis was defined as achieving a 24h bleeding-free period within the first 48h after treatment together with stable vital signs based on Baveno consensus criteria.
Very early rebleeding was defined as: UGI bleeding occurred after initial hemostasis and within 5 days after enrollment. UGI bleeding was proven to be from esophageal varices.
Treatment failure is defined as failure to control acute bleeding episodes or very early rebleeding.
National Science Council, Taiwan is the lead sponsor of 18 studies on the registry; none are open to participants now.
Counted across the registry records on this site, refreshed daily.
Patients presenting with acute esophageal variceal bleeding proven by emergency endoscopy within 12 hours. (Acute esophageal variceal bleeding was defined as:
Exclusion criteria:
add pantoloc to reduce ulcer bleeding after banding ligation
Drug: pantoloc (proton pump inhibitor)
Arm B, intervention: ligation + terlipressin 1mg q6h
Drug: terlipressin (vasoconstrictor)
Ligation plus terlipressin 1mg q6h
Also known as: vasoconstrictor
Pantoloc infusion (1 vial q.d.); Using pantoloc to reduce rebleed after EVL
Also known as: proton pump inhibitor
very early rebleeding
Time frame: 5 days
mortality, complications
Time frame: 42 days
No study locations are listed for this record.
This study is status unknown, as verified in Mar 2009. You cannot join it, but the record below documents what was studied.
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National Science Council, Taiwan