Upper GI bleed: varices: adding octreotide to sclerotherapy reduced rebleeding and death

Clinical bottom line (level 1b)

  1. Patients with cirrhosis and a recent variceal bleed who received sclerotherapy and octreotide compared with sclerotherapy alone were less likely to rebleed (NNT = 3 at 6 months) or die (NNT = 3 at 6 months) .
Jenkins et al: British Medical Journal 1997; 315: 1338-1341
Expires December 2002

The study

Unblinded ?concealed randomised trial with intention-to-treat
Setting: university hospital, UK

32 patients (aged mean 57, 56% male) with cirrhotic portal hypertension and a first variceal bleed six weeks previously

Excluded if
  • cirrhosis not confirmed on liver biopsy

Control Group: (n = 16, 16 analysed): no intervention
Experimental Group: (n = 16, 16 analysed): octreotide 50 micrograms subcut. twice daily for 6 months
All patients had injection sclerotherapy using ethanolamine every 3 weeks until oesophageal varices were obliterated
100% followed for 6 months

The evidence

Outcome Time to outcome CEREERRRR
(95% CI)		ARR
(95% CI)		NNT
(95% CI)
recurrent variceal bleed 6 months 7
(43.8%)		 1
(6.25%)		 86%
(-3% to 98%)		 37.5%
(10.5% to 64.5%)		 3
(2 to 10)
death weeks 5
(31.3%)		 0
(0.0%)		 100%
(% to %)		 31.3%
(8.54% to 54.0%)		 3
(2 to 12)

Citation

  1. Jenkins SA, Baxter JN, Critchley M, et al: randomised trial of octreotide for long term management of cirrhosis after variceal haemorrhage. British Medical Journal 1997; 315: 1338-1341
Search Terms: citation in Cochrane review
Contributor: Chris Ball and Musab Hayatli, December 1999
Reviewer:

Clinical Question.
Patient recent variceal haemorrhage
Intervention or Exposure sclerotherapy and octreotide
Comparison sclerotherapy
Outcome rebleeding, death