There are a number of ways that people can become unwell or die from this serious form of liver disease. One of them is bleeding from the stomach, or oesophagus, caused by swollen veins, medically known as oesophageal varices.
When varices are large they can be treated with beta blockers – commonly used medicines that can reduce the blood pressure inside and around the liver and therefore reduce their size. However, it is unclear whether beta blockers are also an effective treatment for small varices. The BOPPP trial, led by King’s College Hospital, hopes to answer this question.
Nationally, the project plans to recruit 1,200 patients onto the study. Participants will be randomised into one of two groups, receiving either beta-blockers or a placebo.
Our Access and Medicine research team will be offering adult patients with small oesophageal varices the opportunity to join the study, and hope to recruit 36 participants over the next two years. Participants will be closely observed for three years for bleeding from their varices or other complications of cirrhosis. They will also be asked about side effects of taking beta blockers.
To evaluate the effectiveness of beta blockers, the study will assess whether the drug’s side effects justify the potential benefits of reducing the risk of bleeding. It will also measure the impact of beta blockers on the overall costs to the NHS when caring for people with cirrhosis.
Leading the study for the Royal Surrey site is Dr Marinos Pericleous, Consultant Hepatologist and Gastroenterologist. He said: “Royal Surrey is once again at the cutting edge of innovative national research on liver disease. We are delighted to be able to offer our patients the opportunity to participate in this landmark study. We estimate that the use of beta blockers in patients with small Grade 1 varices will significantly reduce the likelihood of developing life-threatening bleeding and improve survival in patients with liver cirrhosis. We encourage all our liver patients with known varices to discuss this opportunity with their hepatologist next time they are in the clinic.”
More details about the study can be found on the British Society of Gastroenterology website.