Propranolol in Chronic Liver Disease: A Controlled Trial of its Effect and Safety over Twelve Months

The effect and safety of propranolol (Inderal-LA) in 95 patientswith mild to moderate chronic liver disease was studied in adouble-blind placebo controlled trial. Over a 12-month period,three patients in the propranolol group died compared with eightin the control population. Upper gastrointestinal bleeding occurredin the placebo group only. Twenty-five patients were withdrawn,12 in the propranolol and 13 in the placebo group. No deteriorationin clinical condition or liver function tests was observed inthe propranolol-treated patients, although serum testosteronelevels fell significantly compared with the control patients.This study shows that long-term treatment with propranolol issafe in patients with chronic liver disease but further studiesare required to define whether or not patients will benefit.Our observations on the response to placebo suggest that a significantproportion of patients are not likely to tolerate drug treatmentfor portal hypertension well.