Randomized controlled study of propranolol for prevention of recurrent esophageal varices bleeding in patients with cirrhosis

ABSTRACT— A randomized controlled trial of propranolol was conducted in 36 adult cirrhotic patients after active esophageal variceal hemorrhage had been controlled. Seventy‐eight percent of the 18 patients on propranolol and 72% of the patients on a placebo were of Pugh's class A. Of the patients treated with propranolol, 94%, 87%, 68% and 57% were free from rebleeding 6, 12, 18 and 24 months after entry, respectively. The corresponding figures in control patients were 81%, 59%, 30% and 15%, respectively. The percentages of patients free from rebleeding were significantly higher in the propranolol group than in the control group (P < 0.05). No significant adverse effect was observed during the study, except for a patient who developed hepatic decompensation 14 months after propranolol therapy. It was concluded that propranolol was a safe and effective drug for the prevention of variceal rebleeding in patients with good liver functional reserve.