London hospital trials use of blood pressure medication to treat liver disease


An NHS hospital in south London will trial the use of blood pressure medication to treat liver disease.

The BOPPP trial, run by King’s College Hospital NHS Trust, will assess whether common beta blocker carvedilol could be used to prevent severe symptoms of cirrhosis.

Cirrhosis is scarring of the liver caused by long-term liver damage. The scar tissue prevents the liver from working properly and causes pressure changes inside the abdomen.

This causes the oesophagus veins to swell, which can lead to fatal bleeding and other life-threatening complications.

Around 4,000 people die from cirrhosis in the UK every year and 700 with the condition need a liver transplant to survive.

Researchers are seeking to recruit a total of 740 patients who have liver cirrhosis and swelling of the veins in the oesophagus – referred to as ‘varices’ - from across the UK by early next year.

Participants will be randomly selected to take carvedilol or placebo tablets, which are made to resemble carvedilol tablets. They will take one or two tablets a day and receive regular blood tests and follow-up appointments at King’s College Hospital.

Carvedilol is used to treat high blood pressure and helps prevent heart disease and heart attacks.

The trial will investigate whether complications from bleeding, fluid build-up, confusion, and infections can be prevented in cirrhosis by using the drug.

Dr Mark McPhail, a Consultant in Liver Critical Care at the Institute of Liver Studies at King’s College Hospital and Principal Investigator for the BOPPP trial, said the trial was “vital to understand more about effective treatments and interventions for patients with liver disease”.

“The results of this trial will improve their quality of life and improve clinicians’ understanding of the disease.”

Lee Milan, 42, from Sevenoaks, was recruited in August 2022 and will remain on the trial for a further two years.

He told the Standard: “I’m taking each day as it comes, but I’m feeling in a good place mentally and trying to stay as healthy as possible.

“The research team has transformed my life and given me a positive outlook on living with a lifelong condition.

“The cirrhosis has caused me to lose a lot of my strength. I get tired quickly, too and struggle to sleep easily. However, I am trying to keep as active as possible. I also have plenty of support, and I know I can speak to my family or the BOPPP trial team at King’s College Hospital if I need help.”

He added: “This was my first time taking part in a research trial. I urge others to take part in research as you can help yourself, help others and improve things for future generations.”

Anyone interested in enrolling on the BOPPP trial can do so here.

The BOPPP trial is supported by the National Institute for Health and Care Research (NIHR).