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TITLE:

A RANDOMIZED CLINICAL TRIAL TO COMPARE THE EFFICACY OF PROPRANOLOL AND CARVEDILOL FOR TREATMENT OF PORTAL HYPERTENSION IN LIVER CIRRHOSIS

AUTHORS:

Dr. Atiqa Ramzan, Dr. Zarmina Naz, Dr. Uroosa Sohail

ABSTRACT:

Aim of Study: The aim of our study was to compare the efficacy of different doses of propranolol and carvedilol for treatment of portal hypertension in patients of liver cirrhosis. Study Design: A randomized clinical trial. Place and Duration: We conducted this study for the duration of one year in medical department of Services hospital, Lahore for the duration of six months from 1st December, 2019 to 30th May, 2020. Methodology: After ethical approval of the study, 100 confirmed cases of liver cirrhosis with portal hypertension of ages 16 to 85 years with either gender were selected for this study by non-probability purposive sampling. These cases were randomly named as group A (I), A (II) & B (I), B (II). In group A (I) & (II) patients were given propranolol (20mg), Carvedilol (6.25mg) and group B (I) & (II) patients were given propranolol (40mg), carvedilol (12.5mg). Portal hypertension was labeled as portal flow velocity >12cm H2O/sec on Doppler ultrasonography. Portal flow velocity (PFV) was measured before and 90 minutes after administration of trial drugs and >20% decrease in portal flow velocity from baseline was considered as efficacy. Results: The mean age of the patients in group A was 48±14.4 years and in group B was 54 ±12.4 years. In group A (I), the mean portal flow velocity at baseline was 22.16±4.28 cm H2O/sec and after treatment at 90 minutes mean portal velocity was 18.12±4.14 cm H2O/sec. In group A (II), the mean portal flow velocity at baseline was 25.16±4.2 and after treatment at 90-minute mean portal velocity was 13.16±2.42. In group B (I), the mean portal flow velocity at baseline was 25.56±3.54 and after treatment at 90 minutes it was 13.96±3.5.In group B (II), the mean portal flow velocity at baseline was 28.44±4.13 and In group B (I) after treatment at 90 minute mean portal velocity was 10.36±2.49. Conclusion: At the end of our trial we observed that high dose carvedilol was more effective than propranolol as well as low dose of carvedilol in reduction of PFV. Keywords: Liver Cirrhosis, Carvedilol, Portal Flow Velocity, Portal hypertension, Propranolol.

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