Efficacy of Long-acting Octreotide (Sandostatin LAR) in Reducing Portal Pressure in Patients With Cirrhosis

Inclusion criteria

• Cirrhosis documented by biopsy, or suggested by characteristic features on abdominal imaging (nodular appearance, irregular contour) along with impaired synthetic liver function and thrombocytopenia and Child Turcotte Pugh Class A or B.
• presence of small esophageal varices, defined as varices < 5 mm in diameter, without red signs documented on endoscopy within 3 months of enrollment
• age ≥ 18 years

Exclusion criteria

• pregnant, lactating or of child-bearing potential and not practicing acceptable method of birth control
• allergic to sandostatin
• high risk varices on endoscopy carried out within 3 months of assessment (large varices or red signs)
• Child Turcotte Pugh Class C cirrhosis
• hepatocellular carcinoma
• evidence of ongoing alcohol or illicit drug abuse within 6 months of the study
• serum creatinine greater than 2 mg/dL
• platelet count below 50,000 per microliter
• prothrombin time 4 seconds or more greater than control
• human immunodeficiency virus (HIV) positive
• symptomatic gallstones
• previous history of upper gastrointestinal bleeding in the past 3 months, defined as hematemesis and/or melena
• previous history of variceal bleeding
• history of congestive heart failure , unstable angina, sustained ventricular tachycardia, or ventricular fibrillation
• use of any investigational drug within 1 month prior to screening and
• current use of beta blockers or long-acting nitrates, any other drug therapy known to have an influence on portal pressure (diuretics were allowed provided patients were on a stable dose for at least 30 days).