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Control of variceal hemorrhage during the first 5 days of therapy is associated with improved survival. The current mainstay of treatment for acute bleeding involves vasoactive agents combined with endoscopic therapy, but 10% to 20% of patients who receive such treatment will rebleed or continue to bleed. Recent small, uncontrolled studies have suggested that recombinant activated factor VII (rFVIIa) might be effective in controlling variceal hemorrhage.
In a multicenter, double-blind trial, the efficacy and safety of rFVIIa were evaluated in a high-risk population of cirrhotic patients with severe liver disease (Child-Pugh score >8) and active variceal bleeding. The 256 participants all received a vasoactive agent and therapeutic endoscopy.…