The Efficacy of HCP407 in Reducing Dysphagia and Chest Pain Following Esophageal Variceal Ligation in Patients with Cirrhosis. Preliminary Results of a Prospective Randomized Study

Aims Endoscopic band ligation (EBL) is the preferred endoscopic treatment for esophageal varices (EV) due to its effectiveness and safety profile. However, it frequently results in adverse effects such as dysphagia and chest discomfort. An over-the-counter medication containing hyaluronic acid, chondroitin sulfate, and poloxamer 407 (HCP407/Esoxx One), commonly used for treating gastroesophageal reflux, may offer therapeutic benefits in this context. This study aims to evaluate the efficacy of HCP407 in alleviating dysphagia and chest discomfort associated with EBL and to assess its effect on the healing of post-EBL ulcerations [1] [2] [3].

Methods All patients undergoing EBL at Hospital Clinic of Barcelona from October 2021 to May 2024 were prospectively included in this study. Participants were randomized into two groups: one group received HCP407 treatment following EBL, while the control group did not receive any treatment. Dysphagia was assessed using the validated Brief Esophageal Dysphagia Questionnaire (BEDQ) on days 3 and 7 post-procedure. Baseline and follow-up endoscopies (conducted at 3–4 weeks) provided additional clinical data for analysis.

Results Of the 31 patients initially enrolled and randomized, 29 completed the study and were analyzed. Most participants were male (82.8%), with a mean age of 63.3 years, and alcohol-related cirrhosis as the primary cause of EV. The HCP407-treated group reported lower dysphagia scores (mean BEDQ total score) on both day 3 (5 vs. 10.46 points) and day 7 (0.75 vs. 2.23 points) compared to the control group; however, these differences were not statistically significant. No significant differences were observed in the resolution rate of post-EBL ulcerations between groups.

Conclusions Post-EBL treatment with HCP407 reduces the incidence and severity of dysphagia and chest discomfort, potentially benefiting patient comfort. However, a larger sample size is necessary to determine the statistical significance of these findings.

Publication History

Article published online:
27 March 2025

• References

• 1 Villa E, Bianchini M, Blasi A, Denys A, Giannini EG, de Gottardi A. et al. EASL Clinical Practice Guidelines on prevention and management of bleeding and thrombosis in patients with cirrhosis. Journal of Hepatology 2022; 76 (05): 1151-84
• 2 Angeli P, Bernardi M, Villanueva C, Francoz C, Mookerjee RP, Trebicka J. et al. EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis. Journal of Hepatology 2018; 69 (02): 406-60
• 3 Cárdenas A, Fernández-Simon A, Escorcell A.. Endoscopic band ligation and esophageal stents for acute variceal bleeding Clinics in Liver Disease. W.B. Saunders. 2014; 18 p793-808.