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582A AASLD ABSTRACTS HEPATOLOGY, October, 2015 Disclosures: Juan Carlos Garcia-Pagan - Consulting: Novartis; Grant/Research Support: GORE Jaime Bosch - Consulting: Falk, Gilead Science, Intercept Therapeutics, Conatus Pharmaceuticals, Exalenz, Almirall, Chiasma Guadalupe Garcia-Tsao - Advisory Committees or Review Panels: Abbvie, Fibrogen The following authors have nothing to disclose: Agustin Albillos, Javier M. González, David Arroyo-Manzano, Javier Zamora, Irfan Ahmad, Joaquin de la Peña, Gin-Ho Lo, Shiv K. Sarin, Juan Abraldes 746 Serum lysyl oxidase-like-2 (sLOXL2) is correlated with the hepatic venous pressure gradient (HVPG) in patients with cirrhosis due to hepatitis C Nezam H. Afdhal 1 , Gregory T. Everson 2 , José Luís Calleja 3 , Geoff McCaughan 4 , Tarik Asselah 5 , Robert P. Myers 6 , Raul E. Aguilar Schall 6 , Jill M. Denning 6 , Diana M. Brainard 6 , Mani Subramanian 6 , John G. McHutchison 6 , Michael R. Charlton 7 , Edward J. Gane 8 , Xavier Forns 9 , Jaime Bosch 9 ; 1 Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA; 2 University of Colorado Denver, Aurora, CO; 3 Hospital Puerta de Hierro, Madrid, Spain; 4 Royal Prince Alfred Hospital, University of Sydney, Sydney, NSW, Australia; 5 Service d’Hépatologie, Hôpital Beaujon, Clichy, France; 6 Gilead Sciences, Inc., Foster City, CA; 7 Intermountain Medical Center, Murray, UT; 8 University of Auckland, Auckland, New Zealand; 9 Liver Unit, Hospital Clinic, IDIBAPS and CIBEREHD, Barcelona, Spain Background: Noninvasive predictors of clinically significant portal hypertension (CSPH) are limited. Our aim was to determine the association between sLOXL2, an enzyme involved in collagen cross-linkage, and the HVPG in patients with portal hypertension due to hepatitis C virus (HCV)-related cirrhosis. Methods: The study included patients with portal hypertension due to HCV-related cirrhosis who achieved a sustained virologic response (SVR12) to a 48-week course of sofosbuvir (SOF) and ribavirin (RBV) in study GS-US-334-0125. HVPG was measured according to a standardized protocol with centralized review at baseline and the end of treatment (EOT). A hemodynamic response was defined as a reduction in HVPG to
HEPATOLOGY, VOLUME 62, NUMBER 1 (SUPPL) AASLD ABSTRACTS 583A fixed effects model to assess the primary outcome (incidence of gastric variceal rebleeding) and secondary outcomes (complete obliteration of gastric varices, aggravation of esophageal varices and mortality rate). Review Manager 5.3 software program was utilized for statistical analysis. Results: The search yielded three <strong>studies</strong> involving 206 patients. The mean percentage of patients with gastric variceal rebleeding was 21% in the EIT group and 4% in the BRTO group, with a mean odds ratio of 0.13, P < 0.01 (95% CI: 0.03-0.47).The percentage of patients with complete obliteration of gastric varices was 74% in the EIT group and 95% in the BRTO group: odds ratio 9.40, P < 0.01 (95% CI: 2.32-38.02). There was no significant difference for aggravation of esophageal varices and mortality rate between the two groups. Conclusions: Balloon-occluded retrograde transvenous obliteration was more effective than endoscopic injection therapy in the eradication of GV and prevention of rebleeding. Rebleeding rate BRTO vs EIT (6.1% vs 6.5%, p=1.000) and 5-day mortality (5.3% vs 4.9%, p=1.000) in PPI group and control group. PPI group showed less 6-week rebleeding rate (12.1 % vs 22.8%, p=0.031) than control group while 6-week mortality was similar between two groups (7.6% vs 6.5% respectively, p=0.810). PPI group showed better event free survival compared to control group over control group (p=0.019 by Log Rank test). Multivariate analysis identified Child-Pugh score as a predictor for 5-day treatment failure (HR 1.648, 95%CI 1.139-2.384, p=0.008). Child-Pugh score and PPI therapy were identified as independent predictors for 6-week treatment failure (HR, 1.328, 95%CI 1.096-1.610 p=0.004 and HR, 0.465, 95%CI 0.233-0.931, p=0.031). The occurrence of serious infection was similar between two groups (3.8% and 6.5%, respectively p=0.399) Conclusion: PPI therapy can offer advantage of decrease the rate of recurrent bleeding in cirrhotic patients with acute variceal bleeding. PPI could be safely used in patients with liver cirrhosis by careful selection of candidate. Cox’s univariate and multivariate analysis of predictors of 6-week treatment failure Disclosures: The following authors have nothing to disclose: Dina Ahmad, Mohammad Esmadi, Shadi Hamdeh, Kunut Kijsirichareanchai, Chijioke U. Enweluzo, Saurabh Kapur, Marco A. Olivera-Martinez 749 Prospective validation of the efficacy of proton pump inhibitors in acute gastroesophageal variceal bleeding in patients with cirrhosis: A single center case-control study Soo Young Park 1 , Se Young Jang 1 , Su Hyun Lee 1 , Yu Rim Lee 1 , Sun Kyung Jang 1 , Won Young Tak 1 , Young Oh Kweon 1 , Jeong Heo 2 , Hyun Young Woo 2 , Won Lim 2 , Jung Gil Park 3 , Keun Hur 4 , Gyeonghwa Kim 4 , Yong-Hun Choi 4 ; 1 Hepatology, Kyungpook National University Hospital, Daegu, Korea (the Republic of); 2 Department of Internal Medicine, Pusan National University Hospital, Pusan, Korea (the Republic of); 3 Internal Medicine, CHA University Gumi CHA Medical Center, Gumi, Korea (the Republic of); 4 Department of Biochemistry, Kyungpook National University, Daegu, Korea (the Republic of) Background and aims: The efficacy and safety of PPI in patient s with acute variceal bleeding have not evaluated yet. Therefore, we aimed to determine the efficacy and safety of long-term proton pump inhibitors in acute gastroesophageal bleeding by reviewing prospective cohort of patients with liver cirrhosis. Patients and methods: Patients with acute variceal bleeding were prospectively evaluated for 5-day in-hospital failure, 6-week failure and recurrent bleeding afterwards. A total of 353 patients with liver cirrhosis visited for acute variceal bleeding from 2008 to 2013. We enrolled 255 patients by excluding 47 patients with non-variceal bleeding and 51 with HCC with portal vein thrombosis. Patients were prospectively evaluated according to previous protocols evaluating treatment outcome in acute gastroesophageal variceal bleeding (Hepatology 2015;61:1033) Five day in-hospital treatment failures were determined by Baveno V criteria and rebleeding within 6 weeks were prospectively evaluated Results: No differences were observed regarding baseline characteristics of patients with PPI group (n=132) and control group (n=123). There were no significant differences in 5-day treatment failure rate Disclosures: Won Young Tak - Advisory Committees or Review Panels: Gilead Korea; Grant/ Research Support: SAMIL Pharma; Speaking and Teaching: Bayer Korea Jeong Heo - Advisory Committees or Review Panels: Abbvie; Grant/Research Support: Roche The following authors have nothing to disclose: Soo Young Park, Se Young Jang, Su Hyun Lee, Yu Rim Lee, Sun Kyung Jang, Young Oh Kweon, Hyun Young Woo, Won Lim, Jung Gil Park, Keun Hur, Gyeonghwa Kim, Yong-Hun Choi 750 Atorvastatin and propranolol combination cause greater reduction of HVPG than propranolol alone in patients of cirrhosis with portal hypertension Saptarshi Bishnu 1 , Avik Sarkar 2 , Saswata Chatterjee 1 , Sk Mahiuddin Ahammed 1 , Kshaunish Das 3 , Kausik Das 1 , Gopal K. Dhali 3 , Abhijit Chowdhury 1 ; 1 Department of Hepatology, School of Digestive and Liver Diseases, Institute of Postgraduate Medical Education and Research, Kolkata, India; 2 Department of GI Radiology, School of Digestive and Liver Diseases, Institute of Postgraduate Medical Education and Research, Kolkata, India; 3 Department of Gastroenterology, School of Digestive and Liver Diseases, Institute of Postgraduate Medical Education and Research, Calcutta, India Introduction:Statins can modulate portal microvascular dynamics in cirrhotic patients. We present preliminary data from a study aimed at comparing combination of propranolol (Ppnl) and atorvastatin versus Ppnl alone in reducing portal pressure in cirrhosis. Methods:In this open-label study, 23 consecutive cirrhotic patients were randomized into Arm A (atorvastatin 20 mg daily with Ppnl in incremental dose, n=11) or Arm B (incremental dose Ppnl, n=12). Hepatic venous pressure gradient (HVPG) was estimated at baseline and after 30 days. Results:The 2 arms were matched with respect to etiology, Child status and baseline HVPG (Table 1). Decrease of wedged hepatic venous pressure, free hepatic venous pressure and HVPG in Arm A and Arm B after 30 days were 6.09±3.56 vs 4.67±2.57 (p=0.290), 1.27±1.67 vs 1.83±2.62 (p=0.546) and 4.81±2.82 vs 2.58±1.88 mm Hg (p=0.041) respectively. Conclusion:HVPG decrease in cirrhotics treated with atorvasta-
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1000A AASLD ABSTRACTS HEPATOLOGY, O
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1312A AUTHOR INDEX HEPATOLOGY, Octo
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1366A CATEGORY INDEX HEPATOLOGY, Oc
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