Octreotide versus Terlipressin as Adjuvant to Endoscopic Variceal Band Ligation in Bleeding Oesophageal Varices: A Systematic Review and Meta-Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Registration
2.2. Case Definition and Intervention
2.3. Search Strategy
2.4. Study Selection
2.5. Outcomes
2.6. Data Extraction Process
2.7. Risk of Bias/Quality Assessment
2.8. Statistical Analysis
3. Results
3.1. Search Results
3.2. Quality Assessment
3.3. Outcomes
3.3.1. Achieving Haemostasis within 24 h
3.3.2. Rebleeding after Achieving Haemostasis
3.3.3. Mortality
3.4. Funnel Plots
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Database | Search Within | Number of Results | Key Words |
---|---|---|---|
All fields | P ((gastrointestinal OR oesophageal OR esophageal OR varices OR variceal) AND (haemorrhage OR hemorrhage OR bleeding)) AND I (terlipressin OR somatostatin OR octreotide OR vasopressor OR vasoconstrictor OR vasoactive) AND O (haemostasis OR hemostasis OR efficacy OR effective OR “bleeding control”) | ||
PubMed | (Filter: Randomized Clinical Trials, English) | 364 | |
Scopus | (Filter: TITLE-ABS-KEY, Medicine, Article, Journal, Final, English only) | 811 | |
Cinahl | (Filter: Academic journals, All adults, English only) | 94 |
Author, Year, Country | Objective | Study Design | Sample Size | Outcomes | Findings |
---|---|---|---|---|---|
Asad et al. 2014 [31] Pakistan. | To compare the efficacy and safety of terlipressin versus octreotide as an adjuvant therapy to EVBL in patients with EVB. | Randomized control trial. Open label study. | terlipressin: 40 octreotide: 40 | Rate of achieving haemostasis within 24 h. Five-day and 30-day rebleeding. Five-day and 30-day mortality. | Rate of achieving haemostasis terlipressin: 97.5% (39/40 patients) octreotide: 87.5% (35/40 patients) p > 0.5 Rebleeding rates at 5 days: terlipressin 5% (2/40 patients) octreotide: 7.5% (12/43 cases) p > 0.5 Rebleeding rates at 30 days: terlipressin 10% (4/40 patients) octreotide: 10% (4/40 patients) p > 0.5 Mortality rate at 5 days terlipressin: 5% (2/40 patients) octreotide: 7.5% (3/40 patients) p > 0.5 Mortality rate at 30 days terlipressin: 10% (4/40 patients). octreotide: 12.5% (5/40 patients). p > 0/05. |
Cho et al. 2006 [32] Korea | To compare the efficacy and safety of terlipressin versus octreotide as an adjuvant therapy to EVBL in patients with EVB. | Randomized control trial. Open label study. | terlipressin: 43 octreotide: 45 | Rate of achieving haemostasis within 24 h. Five-day and 42-day rebleeding. Forty two-day mortality. | Rate of achieving haemostasis terlipressin: 98% (42/43) octreotide: 96% (43/45) p > 0.05 Rebleeding rate at 5 days terlipressin: 12% (5/43) octreotide: 9% (4/45 cases) p > 0.05 Rebleeding rate at 42 days terlipressin: 28% (6/43) octreotide: 24% (11/45 cases), p > 0.05 Mortality rate at 42 days terlipressin: 14% (6/43) octreotide: 18% (8/45) p > 0.05 |
Seo et al. 2014 [33] Korea | To evaluate the control of bleeding, prevention of rebleeding, and survival during 5 days of treatment when comparing terlipressin versus octreotide as adjuvant therapy to EVBL in patient with EVB. | Randomized control trial. Open label study. | terlipressin: 261 octreotide: 260 | Rate of achieving haemostasis within 24 h. Five-day rebleeding. Five-day and 42-day mortality. | Rate of achieving haemostasis. terlipressin: 90% (234/261) octreotide: 87% (227/260) p > 0.05 Rebleeding rate at 5 days terlipressin: 3% (8/261) octreotide: 4% (10/260) p > 0.05 Mortality rate at 42 days terlipressin: 13% (34/261) octreotide: 12% (30/260) p > 0.05 |
Abid et al. 2009 [34] Pakistan | To compare the efficacy and safety of terlipressin versus octreotide as an adjuvant therapy to EVBL in patients with EVB. | Randomized control trial. Double blinded study. | terlipressin: 163 octreotide: 161 | Rate of achieving haemostasis within 24 h. Mortality within hospital stay. | Rate of achieving haemostasis terlipressin: 96.9% (158/163) octreotide: 99.4% (160/161) p > 0.05 Mortality (at any time) terlipressin: 8% (9/163) octreotide: 9% (7/161) p > 0.05 |
Asif et al. 2020 [35] Pakistan | To compare rebleeding rates of terlipressin versus octreotide as an adjuvant therapy to EVBL in patients with EVB. | Randomized control trial. Open label study. | terlipressin: 50 octreotide: 50 | Three-day rebleeding | Rebleeding at 3 days terlipressin: 8% (4/50) octreotide: 28% (14/50) p < 0.05 |
Adarsh et al. 2009 [36] Pakistan | To compare the efficacy and safety of terlipressin versus octreotide as an adjuvant therapy to EVBL in patients with EVB. | Randomized control trial. Open label study. | terlipressin: 69 octreotide: 68 | Rate of achieving haemostasis within 24 h. Forty two-day rebleeding. Forty two -day mortality. | Rate of achieving haemostasis terlipressin: 81% (56/69) octreotide: 75% (51/68) p > 0.05 Rebleeding at 42 days terlipressin: 16% (11/69) octreotide: 27% (18/68) p > 0.05 Mortality at 42 days Terlpressin: 10% (7/69). octreotide: 18% (12/68) p > 0.05 |
Kim et al., 2005 [37] Korea | To compare the efficacy and safety of terlipressin versus octreotide as an adjuvant therapy to EVBL in patients with EVB. | Randomized control trial. Open label study. | terlipressin: 36 octreotide: 37 | Rate of achieving haemostasis within 24 h. Forty two-day rebleeding. Forty two-day mortality. | Rate of achieving haemostasis terlipressin: 92% (33/36) octreotide: 85% (35/37) p > 0.05 Rebleeding at 42 days terlipressin: 5.5% (2/36) octreotide: 8.1% (3/37) p > 0.05 Mortality at 42 days Terlpressin: 2.8% (1/36). octreotide: 5.4% (2/37) p = 0.572 |
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Sadeq, A.A.; Abou Khater, N.; Issa, F.A.; Al-Rifai, A. Octreotide versus Terlipressin as Adjuvant to Endoscopic Variceal Band Ligation in Bleeding Oesophageal Varices: A Systematic Review and Meta-Analysis. Gastroenterol. Insights 2024, 15, 396-408. https://doi.org/10.3390/gastroent15020028
Sadeq AA, Abou Khater N, Issa FA, Al-Rifai A. Octreotide versus Terlipressin as Adjuvant to Endoscopic Variceal Band Ligation in Bleeding Oesophageal Varices: A Systematic Review and Meta-Analysis. Gastroenterology Insights. 2024; 15(2):396-408. https://doi.org/10.3390/gastroent15020028
Chicago/Turabian StyleSadeq, Ahmed A., Noha Abou Khater, Farah Ahmed Issa, and Ahmed Al-Rifai. 2024. "Octreotide versus Terlipressin as Adjuvant to Endoscopic Variceal Band Ligation in Bleeding Oesophageal Varices: A Systematic Review and Meta-Analysis" Gastroenterology Insights 15, no. 2: 396-408. https://doi.org/10.3390/gastroent15020028