The Effect of Liraglutide on β-Blockade for Preventing Variceal Bleeding: A Case Series
Authors: Ranka Vukotic, Francesco Raimondi, Lucia Brodosi, Giovanni Vitale, Maria Letizia Petroni, Giulio Marchesini, Pietro Andreone
Journal: Annals of Internal Medicine (2020)

Letters1 September 2020The Effect of Liraglutide on β-Blockade for Preventing Variceal Bleeding: A Case SeriesRanka 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, MDRanka Vukotic, MD, PhDUniversity of Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy (R.V., L.B., G.V., M.L.P., G.M., P.A.), Francesco Raimondi, PhDLaboratory of Biology, Scuola Normale Superiore, Pisa, Italy (F.R.), Lucia Brodosi, MD, PhDUniversity of Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy (R.V., L.B., G.V., M.L.P., G.M., P.A.), Giovanni Vitale, MD, PhDUniversity of Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy (R.V., L.B., G.V., M.L.P., G.M., P.A.), Maria Letizia Petroni, MD, PhDUniversity of Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy (R.V., L.B., G.V., M.L.P., G.M., P.A.), Giulio Marchesini, MDUniversity of Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy (R.V., L.B., G.V., M.L.P., G.M., P.A.), and Pietro Andreone, MDUniversity of Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy (R.V., L.B., G.V., M.L.P., G.M., P.A.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L20-0041 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail 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: To provide information about ...References1. 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 CrossrefMedlineGoogle Scholar2. 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 CrossrefMedlineGoogle Scholar3. 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 CrossrefMedlineGoogle Scholar4. 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 CrossrefMedlineGoogle Scholar5. 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] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy (R.V., L.B., G.V., M.L.P., G.M., P.A.)Laboratory of Biology, Scuola Normale Superiore, Pisa, Italy (F.R.)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, ranka.[email protected]it or [email protected]it.This article was published at Annals.org on 26 May 2020. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byThe treatment of diabetes in advanced liver disease: change of a paradigmRisk of adverse events with liraglutide in heart failure with reduced ejection fraction: A post hoc analysis of the FIGHT trialPRECOGx: e x ploring GPCR signaling mechanisms with deep protein representationsGlucagon-Like Peptide-1 Receptor Agonists and Hepatic Decompensation Events in Patients With Cirrhosis and DiabetesManagement of Diabetes in Candidates for Liver Transplantation and in Transplant RecipientsDiabetestherapie bei fortgeschrittenen Lebererkrankungen und LeberzirrhoseConsiderations when prescribing pharmacotherapy for metabolic associated fatty liver diseaseNutrition in Patients with Type 2 Diabetes: Present Knowledge and Remaining ChallengesLiraglutide/propranolol interaction 1 September 2020Volume 173, Issue 5Page: 404-405KeywordsCellsCirrhosisDisclosureHeart rateHemorrhageLongitudinal studiesOverweightParoxysmal supraventricular tachycardiaSympathetic nervous systemType 2 diabetes ePublished: 26 May 2020 Issue Published: 1 September 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...