5-MTHF enhances the portal pressure reduction achieved with propranolol in patients with cirrhosis: A randomized placebo-controlled trial.

Currently, the pharmacological prevention of cirrhosis complications due to portal hypertension, as esophageal varices rupture, is based on the use of β-blockers, but some patients still present acute variceal bleeding, mainly due to an insufficient reduction of portal pressure. In this study, we sought to demonstrate that the addition of folic acid to β-blockers is more effective in reducing portal pressure than β-blockers alone. This finding could represent a basis for validation studies in larger cohorts to potentially impact the future management of pharmacological prophylaxis of variceal bleeding in cirrhosis. Enhancing the benefit of β-blockers by a safe, accessible, cost-effective drug could improve clinical outcomes in cirrhosis which in turn could translate in a reduction of rates and costs of hospitalization, ultimately ameliorating survival. Clinical trial EudraCT number 2014-002018-21.