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Pharmacotherapies for Portal Hypertension: Current Status and Expanding Indications

  • Portal Hypertension and Liver Transplantation (AK Singal, Section Editor)
  • Published:
Current Hepatology Reports Aims and scope Submit manuscript

Abstract

Purpose

Non-selective beta blockers remain the pharmacotherapy of choice for prevention of the first episode of variceal bleeding (primary prevention) and for prevention of its recurrence after initial hemostasis (secondary prophylaxis). This review will update the current and emerging pharmacological therapies for portal hypertension.

Recent Findings

Data have emerged on carvedilol in preventing hepatic decompensation and improving patient survival among patients with clinically significant portal hypertension. Because measurement of WHVP is invasive and not feasible in routine practice, non-invasive tests with liver stiffness measurement in combination with platelet count may be accurate in identifying clinically significant portal hypertension.

Summary

Carvedilol is more effective in reducing portal pressure compared to nadolol or propranolol. Its use has expanded to reduce risk of hepatic decompensation among patients with CSPH, which can be identified non-invasively using liver stiffness and platelet count. Studies are needed on non-invasive biomarkers to guide and optimize pharmacological treatment of portal hypertension.

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Authors and Affiliations

  1. Avera McKennan University Hospital, Sioux Falls, USA

    Mohamed A. Elfeki & Ashwani K. Singal

  2. University of South Dakota Sanford School of Medicine Sioux Falls, Sioux Falls, SD, USA

    Ashwani K. Singal

  3. VA Medical Center, Sioux Falls, SD, USA

    Ashwani K. Singal

  4. Mayo Clinic and Mayo Medical School, Rochester, MN, USA

    Patrick S. Kamath

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  1. Mohamed A. Elfeki
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  3. Patrick S. Kamath
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Correspondence to Patrick S. Kamath.

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Elfeki, M.A., Singal, A.K. & Kamath, P.S. Pharmacotherapies for Portal Hypertension: Current Status and Expanding Indications. Curr Hepatology Rep 22, 44–50 (2023). https://doi.org/10.1007/s11901-023-00600-z

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