Reply to Letter: Nonselective beta blockers versus variceal band ligation, beyond bleeding prophylaxis.

Abstract

We thank Gin-Ho Lo for taking interest in our study and for the comments.(1) Dr. Lo raises important points comparing the different adverse effect profiles of nonselective beta-blockers (NSBB) and variceal band ligation (VBL). Current guidelines still recommend the use of either NSBB or VBLfor the primary prevention of esophageal variceal bleeding and the debate is likely to continue.(2) In our systematic review and network meta-analysis, when compared toVBL, NSBB were associated with higher rate of overall adverse events, resulting in treatment discontinuation. On the other hand, VBL was associated with three times greater number of serious adverse events.(1) Therefore, NSBBs still represent a less invasive prophylactic measure with additional benefits beyond prevention of variceal bleeding in patients with cirrhosis. This article is protected by copyright. All rights reserved.