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The following is a summary of “Comparison of Carvedilol and Propranolol in Reducing the Portal Vein Pressure: A Systematic Review and Meta-analysis,” published in the November 2024 issue of Gastroenterology by Hu et al. 

Elevated portal vein pressure (PVP) above 10 mm Hg in patients with hepatic cirrhosis can lead to serious complications and poor prognosis. Nonselective receptor blockers (NSBBs) are commonly used to reduce PVP. 

Researchers conducted a retrospective study to compare the efficacy and safety of carvedilol vs. propranolol in reducing PVP. 

They assessed RCTs from PubMed, Web of Science, Embase, and Cochrane Library up (January 2024), pooling data in fixed-effect or random-effect models (using Review Manager [RevMan] software), 2 researchers independently screened studies, extracted data, and assessed study quality according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. 

The results showed that carvedilol led to a greater reduction in hepatic venous pressure gradient (HVPG) (mean difference [MD]: 1.08; 95% CI: 0.61 to 1.54; I² =0%, P<0.00001) compared to propranolol in short-term follow-up. Carvedilol also had a higher hemodynamic response rate (OR: 0.44; 95% CI: 0.27 to 0.72; I² =0%, P=0.001). 

They concluded that carvedilol was more effective than propranolol in lowering PVP with no significant difference in safety between the 2 drugs. 

Source: journals.lww.com/jcge/abstract/9900/comparison_of_carvedilol_and_propranolol_in.384.aspx