1-day octreotide infusion not inferior to 5-day regimen for acute esophageal variceal bleeding

The 1-day regimen of octreotide following a successful endoscopic band ligation demonstrates noninferiority to the standard 5-day regimen in preventing 5-day rebleeding, with no significant differences in the prevention of 6-week rebleeding and all-cause mortality, a study has shown.

Some 220 patients with cirrhosis and acute esophageal variceal bleeding who underwent EBL in five tertiary care and three university-based hospitals in Thailand were included in this nationwide, multicentre, noninferiority, open-label, randomized controlled trial.

Participants received a 1-day (n=109) or 5-day (n=111) regimen of continuous octreotide infusion after successful endoscopy. The researchers assessed rebleeding, transfusion requirements, and mortality.

The mean age of the participants was 56 years, and the majority were men (180/220). The rates of 5-day rebleeding (1.83 percent vs 1.80 percent; p≥0.99), 6-week rebleeding (8.26 percent vs 10.81 percent; p=0.52), and 6-week all-cause mortality (5.50 percent vs 6.31 percent; p=0.80) did not significantly differ between the two treatment groups.

A 0.03-percent event-rate difference in early rebleeding was noted, exhibiting noninferiority (95 percent confidence interval, 3.50‒3.56).

Notably, patients who received the 1-day regimen had significantly fewer blood transfusions, a shorter time to oral diet, and shorter hospital stay than their counterparts in the 5-day regimen group.