Early Primary Prophylaxis of Esophageal Varices
Early Primary Prophylaxis of Esophageal Varices
Patients of cirrhosis with portal hypertension aged 18 to 75 years who have small esophageal
 varices with or without red color signs and have not bled previously will be enrolled. After
 baseline evaluation, the participants will be randomized to receive either Placebo or
 Carvedilol 12.5 mg BD. After randomization they will be followed up for one year. The primary
 endpoint of the study is the the proportions of patients who develop large varices (Gd 3 or
 Gd 4) at 1 year in each group. The secondary endpoint are survival,reduction in HVPG,change
 in CTP and MELD score& adverse events.
Inclusion Criteria:

 - Patients of cirrhosis with portal hypertension aged 18 to 75 years who have small
 esophageal varices with or without red color signs and have not bled previously.

 Exclusion Criteria:

 -  Any contra-indication to beta-blockers

 -  Any EVL or sclerotherapy within last 3 months

 -  Child Turcotte Pugh (CTP) score > 12, refractory ascites, hepatorenal syndrome

 -  Any past history of surgery for portal hypertension

 -  Significant cardio or pulmonary co-morbidity

 -  Any malignancy that affects survival.

 -  Active alcohol abuse or last intake ≤ 4 weeks to avoid possibility of ongoing alcohol
 hepatitis.

 -  Past history of surgery for portal hypertension

 -  Uncontrolled diabetes

 -  Peripheral vascular disease

 -  Refusal to participate in the study