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Primary prophylaxis in patients with high risk oesophageal varices to prevent oesophageal variceal bleeding (OVB)—The CAVARLY is stronger together!!
  1. Harsh Vardhan Tevethia1,
  2. Apurva Pande1,
  3. Rajan Vijayaraghavan1,
  4. Guresh Kumar2,
  5. Shiv Kumar Sarin1
  1. 1Hepatology, Institute of liver and Biliary sciences, New Delhi, India
  2. 2Biostatistics, Institute of Liver and Biliary Sciences, New Delhi, India
  1. Correspondence to Professor Shiv Kumar Sarin; shivsarin{at}gmail.com

https://doi.org/10.1136/gutjnl-2024-334130

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    We would like to thank Dunne et al1 for their interest in our work.2 Their main concerns are that the rates of liver-related events (LREs) including progression to ascites were similar in both the groups in spite of lower mortality and oesophageal variceal bleed (OVB) in the combination arm as compared with the other arms. Second, the rates of OVBs and the bleed-related mortality were higher in the carvedilol arm as compared with the other arms.

    We would like to emphasise that in our study, we did not find any significant difference between the carvedilol arm and the combination arm in the reduction of hepatic venous pressure gradient (HVPG). The latter has been shown to correlate with various LREs and their progression.3 The reduction by 10% or …

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    Footnotes

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.