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©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 28, 2015; 21(8): 2265-2268
Published online Feb 28, 2015. doi: 10.3748/wjg.v21.i8.2265
Published online Feb 28, 2015. doi: 10.3748/wjg.v21.i8.2265
Use of non-selective beta blockers in cirrhosis: The evidence we need before closing (or not) the window
Vincenzo La Mura, Francesco Salerno, U.O. Medicina Interna, IRCCS-San Donato, Dipartimento di Scienze Biomediche per la Salute, Università degli studi di Milano, 20097 Milan, Italy
Giulia Tosetti, Massimo Primignani, U.O. Gastroenterologia-1, IRCCS-Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milano, Italy
Author contributions: La Mura V involved in doing major critical content, editing; Tosetti G edited the manuscript; Primignani M did critical revision; Salerno F critical revised the manuscript.
Conflict-of-interest: No potential conflict of interest relevant to this article to disclose.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Vincenzo La Mura, MD, PhD, U.O. Medicina Interna, IRCCS-San Donato, Dipartimento di Scienze Biomediche per la Salute, Università degli studi di Milano, Via Morandi 30, San Donato Milanese, 20097 Milan, Italy. vin.lamura@gmail.com
Telephone: +39-02-52774462 Fax: +39-02-52774462
Received: November 8, 2014
Peer-review started: November 8, 2014
First decision: November 26, 2014
Revised: December 17, 2014
Accepted: January 30, 2015
Article in press: January 30, 2015
Published online: February 28, 2015
Processing time: 111 Days and 21.8 Hours
Peer-review started: November 8, 2014
First decision: November 26, 2014
Revised: December 17, 2014
Accepted: January 30, 2015
Article in press: January 30, 2015
Published online: February 28, 2015
Processing time: 111 Days and 21.8 Hours
Core Tip
Core tip: Non selective beta blockers (NSBBs) treatment in cirrhotic patients is an undisputed strategy for bleeding prophylaxis. Nevertheless recent studies question the efficacy and safety of NSBBs in patient with advanced cirrhosis, particularly in case of refractory ascites and spontaneous bacterial peritonitis. These results suggest that NSBBs have beneficial effects on cirrhosis only in a determinate phase of the liver disease: “window hypothesis”. In our opinion, the evidence produced up to now is by far conclusive to contraindicate NSBBs in patients with advanced cirrhosis.