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26 May 2020

The Effect of Liraglutide on β-Blockade for Preventing Variceal Bleeding: A Case Series

Authors: Ranka Vukotic, MD, PhD, Francesco Raimondi, PhD, Lucia Brodosi, MD, PhD, Giovanni Vitale, MD, PhD, Maria Letizia Petroni, MD, PhD, Giulio Marchesini, MD, and Pietro Andreone, MDAuthor, Article, & Disclosure Information

Publication: Annals of Internal Medicine

Volume 173, Number 5

https://doi.org/10.7326/L20-0041

Background: When using β-blockers to prevent bleeding from esophageal varices, clinicians use the resting heart rate as a guide and aim for a target of 55 to 65 beats/min (1). Glucagon-like peptide-1 (GLP-1) is an incretin produced by L cells in the gut in response to food intake (2). It increases heart rate acutely, mainly via stimulation of the sympathetic nervous system (2). Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are used to treat diabetes because they lower blood glucose levels and are especially useful when the patient is obese and has nonalcoholic fatty liver disease (3).

Objective:

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References

1.

Garcia-Tsao G, Bosch J. Management of varices and variceal hemorrhage in cirrhosis. N Engl J Med. 2010;362:823-32. [PMID: 20200386] doi: 10.1056/NEJMra0901512

2.

Drucker DJ. The cardiovascular biology of glucagon-like peptide-1. Cell Metab. 2016;24:15-30. [PMID: 27345422] doi: 10.1016/j.cmet.2016.06.009

3.

Armstrong MJ, Hull D, Guo K, et al. Glucagon-like peptide 1 decreases lipotoxicity in non-alcoholic steatohepatitis. J Hepatol. 2016;64:399-408. [PMID: 26394161] doi: 10.1016/j.jhep.2015.08.038

4.

Battle A, Brown CD, Engelhardt BE, et al; GTEx Consortium. Genetic effects on gene expression across human tissues. Nature. 2017;550:204-213. [PMID: 29022597] doi: 10.1038/nature24277

5.

Smits MM, Tonneijck L, Muskiet MH, et al. Heart rate acceleration with GLP-1 receptor agonists in type 2 diabetes patients: an acute and 12-week randomised, double-blind, placebo-controlled trial. Eur J Endocrinol. 2017;176:77-86. [PMID: 27777261]

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Information & Authors

Information

Published In

cover image Annals of Internal Medicine

Annals of Internal Medicine

Volume 173 • Number 5 • 1 September 2020

Pages: 404 - 405

History

Published online: 26 May 2020

Published in issue: 1 September 2020

Keywords

Copyright

© 2020 American College of Physicians.

Authors

Affiliations

Ranka Vukotic, MD, PhD

University of Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy (R.V., L.B., G.V., M.L.P., G.M., P.A.)

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Francesco Raimondi, PhD

Laboratory of Biology, Scuola Normale Superiore, Pisa, Italy (F.R.)

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Lucia Brodosi, MD, PhD

University of Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy (R.V., L.B., G.V., M.L.P., G.M., P.A.)

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Giovanni Vitale, MD, PhD

University of Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy (R.V., L.B., G.V., M.L.P., G.M., P.A.)

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Maria Letizia Petroni, MD, PhD

University of Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy (R.V., L.B., G.V., M.L.P., G.M., P.A.)

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Giulio Marchesini, MD

University of Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy (R.V., L.B., G.V., M.L.P., G.M., P.A.)

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Pietro Andreone, MD

University of Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy (R.V., L.B., G.V., M.L.P., G.M., P.A.)

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Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L20-0041.

Corresponding Author: Ranka Vukotic, MD, PhD, Università di Bologna, Policlinico Sant'Orsola-Malpighi, Via Massarenti, 9, 40138 Bologna, Italy; e-mail, [email protected] or [email protected].

This article was published at Annals.org on 26 May 2020.

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Ranka Vukotic, Francesco Raimondi, Lucia Brodosi, et al. The Effect of Liraglutide on β-Blockade for Preventing Variceal Bleeding: A Case Series. Ann Intern Med.2020;173:404-405. [Epub 26 May 2020]. doi:10.7326/L20-0041

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