Treatment with non-selective beta blockers is associated with reduced severity of systemic inflammation and improved survival of patients with acute-on-chronic liver failure

Abstract

This study shows for the first time that ongoing treatment with NSBBs in cirrhosis is safe and reduces the mortality if they develop ACLF. Careful thought should be given before stopping NSBBs in cirrhotic patients.

Secondary prophylaxis for variceal bleeding: carvedilol vs. propranolol

“…Because the debate about the use of NSBB in patients with ascites is still on-going, such data might be of major interest. Recent data showed a benefit of NSBB for patients on the transplant waiting list and for patients with ACLF [5], [6]. Propranolol effects may also be due to properties other than reducing portal pressure.…”

Non-selective beta-blockers for the patients with acute on chronic liver failure

“…We read with great interest the article by Mookerjee et al [1], about the beneficial effects of non-selective beta blockers (NSBBs) in patients with acute on chronic liver failure (ACLF). The authors indicated that 164 of patients on NSBBs had lower grades of ACLF than those not on NSBBs.…”

Spontaneous Bacterial Peritonitis: Is It Still A Life-Threatening Issue in Cirrhosis?

“…It was demonstrated that once SBP has developed patients receiving beta blockers had a 58 % increase in mortality risk compared with patients who did not receive beta blockers [24] . Currently, the use of non selective beta blockers is been widely studied and two large studies found that they could not only be safe in patients with ascites and do not increase mortality as they could also reduce mortality in those that develop acute on chronic liver failure [25,26] . Some studies had demonstrated that proton pump inhibitors [PPI] cannot only favor intestinal overgrowth but also affect cellular activity increasing the risk of developing bacterial infections.…”