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Clinical Takeaway
: A large observational study suggests it is.Context
Professional societies recommend carvedilol over other nonselective beta-blockers in cirrhosis because it reduces portal pressure more effectively, but data on clinical outcomes are limited. Here, using administrative data, researchers retrospectively compared outcomes among 26,000 insured U.S. adults with cirrhosis who filled new prescriptions for carvedilol, propranolol, or nadolol.
Key Results
At baseline, patients who received carvedilol were substantially less likely than propranolol and nadolol recipients to have esophageal or gastric varices. After adjustment for this and other differences, the estimated 6-month incidence of major liver decompensation (hospitalization for ascites, spontaneous bacterial peritonitis, hepatorenal s…