P2450 - Comparison of 72 Hours versus 12-24 Hours Intravenous Terlipressin in Patients With Acute Esophageal Variceal Bleeding: A Systemic Review and Meta-analysis

Award: Presidential Poster Award

Mohammad Al Hayek, MD¹, Abdallah Khashan, MD², Bisher Sawaf, MD³, Ahmed Hassan, MD⁴, Alhasan Saleh. Alzubi, ⁵, Abdussalam Alzein, MD⁶, Abdelrahman Abdelwahed, ⁵, Mohamedhen Vall Nounou, ⁷, Muhammed Elhadi, ^8
1Damascus University, Damascus, Dimashq, Syria; ²Raritan Bay Medical Center, Perth Amboy, NJ; ³University of Toledo Health Sciences Campus, Toledo, OH; ⁴South Valley University, Qina, Qina, Egypt; ⁵Mahsa University, Petaling Jaya, Selangor, Malaysia; ⁶Traghen Teaching Hospital, Tripoli, Tripoli, Libya; ⁷Nouakchott, Nouakchott, Nouakchott, Mauritania; ⁸University of Tripoli, Tripoli, Tripoli, Libya

Introduction: Gastroesophageal variceal bleeding is a major risk for people with liver disease, leading to significant morbidity and mortality. Treatment usually includes endoscopic and drug interventions to control bleeding and avoid recurrence.
This study compares the efficacy of short-term (12-24 hours) versus long-term (72 hours) terlipressin therapy for acute variceal bleeding (AVB) in patients.

Methods: The PRISMA guidelines were followed, and databases like PubMed, Google Scholar, VHL, Cochrane Library, Scopus, Web of Science, and ClinicalTrials.gov were searched. The risk of bias was assessed with Cochrane RoB 2.0, and data extraction was done independently by two
investigators, and reviewed by a third. The meta-analysis used a random-effects model to calculate odds ratios (OR) and 95% confidence intervals (CI) for mortality and rebleeding rates within five days post-treatment.

Results: Three randomized controlled trials (RCTs) with a total of 369 patients were included in the analysis. There were no significant differences observed in mortality rates (OR=0.386; 95%CI: 0.066-2.260; p=0.291) or rebleeding rates (OR=0.752; 95%CI: 0.229-2.46; p=0.63) between terlipressin treatment durations of 12-24 hours and 72 hours within the first five days
post-treatment. Additionally, no heterogeneity was found in either variable (p < 0.1).

Discussion: This meta-analysis indicates no significant difference in mortality or rebleeding rates between 12-24 hours and 72 hours of terlipressin therapy for AVB within five days post-treatment. Shorter treatment durations may offer advantages regarding resource utilization and adverse event risk but require further investigation in larger patient cohorts to establish their efficacy conclusively, however, their efficacy requires further validation through studies involving larger patient populations.


Disclosures:


Mohammad Al Hayek, MD¹, Abdallah Khashan, MD², Bisher Sawaf, MD³, Ahmed Hassan, MD⁴, Alhasan Saleh. Alzubi, ⁵, Abdussalam Alzein, MD⁶, Abdelrahman Abdelwahed, ⁵, Mohamedhen Vall Nounou, ⁷, Muhammed Elhadi, ⁸. P2450 - Comparison of 72 Hours versus 12-24 Hours Intravenous Terlipressin in Patients With Acute Esophageal Variceal Bleeding: A Systemic Review and Meta-analysis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.