Cochrane · systematic review · CD013121
Primary prevention of variceal bleeding in people with oesophageal varices due to liver cirrhosis: a network meta‐analysis
Roccarina, D, Best, LMJ, Freeman, SC, et al. · Cochrane Database of Systematic Reviews · 2021 · Cochrane Library
Hepato-BiliaryAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
34
current version
GRADE rated
32
No studies
2
Included studies
NR
No studies 2 · 5.9%Ungraded 0 · 0%Very low 24 · 70.6%Low 8 · 23.5%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Primary prevention of bleeding in people with oesophageal varices due to liver cirrhosis (all interventions)
Population: people with liver cirrhosis and oesophageal varices with no history of bleeding
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Interventions | no estimate extracted | NR | No studies |
Beta‐blockers | no estimate extracted | NR | No studies |
No active intervention(10 RCTs, 1200 participants) | HR 2.04 [1.5, 2.78] | NR | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Variceal band ligation(17 RCTs, 1640 participants) | HR 1.05 [0.8, 1.38] | NR | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Sclerotherapy(5 RCTs, 320 participants) | HR 1.35 [0.95, 1.92] | NR | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Beta‐blockers + variceal band ligation(2 RCTs, 313 participants) | HR 1.11 [0.56, 2.19] | NR | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Beta‐blockers + nitrates(2 RCTs, 203 participants) | HR 0.84 [0.44, 1.64] | NR | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Nitrates(3 RCTs, 298 participants) | HR 1.19 [0.66, 2.11] | NR | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Beta‐blockers + sclerotherapy(2 RCTs, 167 participants) | HR 2.08 [1.03, 4.08] | NR | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Portocaval shunt(No direct RCT) | HR 0.51 [0.06, 2.92] | NR | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Variceal band ligation(5 RCTs, 372 participants) | OR 0.75 [0.02, 23.24] | NR | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Sclerotherapy(1 RCT, 85 participants) | OR 0.55 [0, 272.05] | NR | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Variceal band ligation(1 RCT, 168 participants) | no estimate extracted | NR | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
No active intervention(2 RCTs, 256 participants) | OR 0.28 [0.02, 2.91] | NR | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Variceal band ligation(7 RCTs, 728 participants) | OR 1.6 [0.54, 5.15] | NR | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Sclerotherapy(No direct RCT) | OR 1.19 [0.02, 80.24] | NR | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Beta‐blockers + nitrates(1 RCT, 57 participants) | OR 3.41 [1.11, 11.28] | NR | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
No active intervention(No direct RCT) | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Variceal band ligation(4 RCTs, 480 participants) | no estimate extracted | NR | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Sclerotherapy(2 RCTs, 90 participants) | no estimate extracted | NR | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Beta‐blockers + variceal band ligation(1 RCT, 140 participants) | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
No active intervention(1 RCT, 161 participants) | HR 1.36 [0.35, 5.8] | NR | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Variceal band ligation(5 RCTs, 380 participants) | HR 1.41 [0.83, 2.43] | NR | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
No active intervention(1 RCT, 140 participants) | HR 1.14 [0.56, 2.4] | NR | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Variceal band ligation(3 RCTs, 330 participants) | HR 0.8 [0.47, 1.36] | NR | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Sclerotherapy(1 RCT, 141 participants) | HR 0.91 [0.44, 1.95] | NR | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Nitrates(1 RCT, 118 participants) | HR 1.27 [0.61, 2.66] | NR | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Beta‐blockers + sclerotherapy(1 RCT, 141 participants) | HR 0.92 [0.41, 2.08] | NR | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
No active intervention(2 RCTs, 208 participants) | HR 2.71 [0.97, 7.68] | NR | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Variceal band ligation(9 RCTs, 879 participants) | HR 0.72 [0.33, 1.51] | NR | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Sclerotherapy(3 RCTs, 175 participants) | HR 1.02 [0.33, 3.27] | NR | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Beta‐blockers + variceal band ligation(1 RCT, 173 participants) | HR 0.21 [0.04, 0.71] | NR | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Nitrates(1 RCT, 52 participants) | HR 6.4 [1.58, 47.42] | NR | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Variceal band ligation(2 RCTs, 130 participants) | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |