Evidence map›Paper›PMID 39740197›Full record

ArticleUnited European gastroenterology journal2025

Secondary Prophylaxis of Cirrhotic Gastric Variceal Bleeding: Addition of Non-Selective Beta-Blockers to Endoscopic Combined Treatment.

Ling Wu, Xiaoquan Huang, Feng Li, Siyu Jiang, Liyuan Ni, Yingjie Ai, Detlef Schuppan, Shiyao Chen

Abstract read
In one paragraph

Article in United European gastroenterology journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Ling WuDepartment of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, Shanghai, China.ORCID 0000-0001-6574-6493
Xiaoquan HuangDepartment of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, Shanghai, China.
Feng LiDepartment of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, Shanghai, China.
Siyu JiangDepartment of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, Shanghai, China.
Liyuan NiDepartment of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, Shanghai, China.
Yingjie AiDepartment of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, Shanghai, China.
Detlef SchuppanInstitute of Translational Immunology and Research Center for Immunotherapy (FZI), University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.
Shiyao ChenDepartment of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, Shanghai, China.

Funding

Deutsche Forschungsgemeinschaft CRC 1292 project B8Deutsche Forschungsgemeinschaft SFB 1066 project B3HORIZON EUROPE European Research Council 634413HORIZON EUROPE European Research Council 777377National Key Research and Development Program of China 2023YFC2507500Shanghai Committee of Science and Technology 22Y11907400
6 · The paper itself

Abstract

backgroundIt remains unclear whether the addition of non-selective beta-blockers (NSBB) provides further benefit after combined use of tissue adhesive and endoscopic variceal ligation for bleeding gastroesophageal varices.

objectiveThis is the first cohort study comparing the secondary prophylactic efficacy of adding NSBB to combined endoscopic treatment in cirrhotic patients with gastric varices (without inclusion of isolated gastric varices [IGVs], which are rare in patients with cirrhosis without splanchnic thrombosis).

methodsWe retrospectively analyzed two matched large cohorts of cirrhotic patients with gastric varices who received combined endoscopic treatment and were assigned to receive NSBB treatment or not as secondary prophylaxis. Further sub-analyses were performed. The 5-year overall survival and rebleeding rates were compared.

resultsA total of 490 patients were enrolled, 130 of whom took NSBB. After propensity score matching (PSM), both groups comprised 130 patients. No significant difference between the NSBB and non-NSBB groups was observed regarding 5-year survival (87.40% vs. 83.64%, HR 0.62, 95% CI 0.33-1.17), while NSBB decreased the 5-year rebleeding rate from 45.7% to 30.64% (HR 0.57, 95% CI 0.39-0.82). The same was true when comparing the 2 groups after PSM. NSBB (HR 0.54, 95% CI 0.37-0.79) and splenectomy (HR 0.65, 95% CI 0.44-0.96) independently reduced rebleeding but did not affect survival. In patients without splenectomy, NSBB treatment improved survival (HR 0.43, 95% CI 0.21-0.89) and reduced rebleeding (HR 0.52, 95% CI 0.34-0.78).

conclusionWe show for the first time that adding NSBB to combined endoscopic therapy significantly reduced recurrent variceal bleeding in cirrhotic patients but did not improve overall survival, except for patients without splenectomy. The addition of NSBB for patients receiving combined endoscopic treatment of gastroesophageal varices provides benefits but does not prolong overall survival.

Indexed as

Adrenergic beta-AntagonistsEsophageal and Gastric VaricesGastrointestinal HemorrhageLiver CirrhosisSecondary PreventionAgedCombined Modality TherapyFemaleHumansLigationMaleMiddle AgedPropensity ScoreRecurrenceRetrospective StudiesTissue AdhesivesAdrenergic beta-AntagonistsTissue Adhesivescirrhosisgastric varicesgastroesophageal varicesgastrointestinal hemorrhageligationNSBBportal hypertensionrebleedingsurvival analysistissue adhesive

Identifiers

PMID39740197
PMCPMC12090826

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.