We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Randomised clinical trial: high-dose vs. standard-dose proton pump inhibitors for the prevention of recurrent haemorrhage after combined endoscopic haemostasis of bleeding peptic ulcers.
- Authors
Chen, C.‐C.; Lee, J.‐Y.; Fang, Y.‐J.; Hsu, S.‐J.; Han, M.‐l.; Tseng, P.‐H.; Liou, J.‐M.; Hu, F.‐C.; Lin, T.‐l.; Wu, M.‐S.; Wang, H.‐P.; Lin, J.‐T.
- Abstract
Summary Background The optimal dosage of intravenous proton pump inhibitors ( PPIs) for the prevention of peptic ulcer rebleeding remains unclear. Aim To compare the rebleeding rate of high-dose and standard-dose PPI use after endoscopic haemostasis. Methods A total of 201 patients with bleeding ulcers undergoing endoscopic treatment with epinephrine injection and heater probe thermocoagulation were randomised to receive a high-dose regimen (80 mg bolus, followed by pantoprazole 8 mg/h infusion, n = 100) or a standard-dose regimen (pantoprazole 40 mg bolus daily, n = 101). After 72 h, all patients were given 40 mg pantoprazole daily orally for 27 days. Results There were no statistical differences in mean units of blood transfused, length of hospitalisation ≦5 days, surgical or radiological interventions and mortality within 30 days between two groups. Bleeding recurred within 30 days in six patients [6.2%, 95% confidence interval ( CI) 1.3-11.1%] in the high-dose group, as compared to five patients (5.2%, 95% CI 0.6-9.7%) in the standard-dose group ( P = 0.77). The stepwise Cox regression analysis showed end-stage renal disease, haematemesis, chronic obstructive pulmonary disease (hazard ratio: 37.15, 10.07, 9.12, 95% CI: 6.76-204.14, 2.07-49.01, 1.66-50.00 respectively) were independent risk factors for rebleeding and Helicobacter pylori infection was associated with lower risk of rebleeding (hazard ratio: 0.20, 95% CI: 0.04-0.94). Conclusions Following combined endoscopic haemostasis of bleeding ulcers, co-morbidities, haematemesis and H. pylori Status, but not PPI dosage, are associated with rebleeding (. ID: NCT00709046).
- Subjects
MEDICAL research; PROTON pump inhibitors; PEPTIC ulcer prevention; HEMOSTASIS; ENDOSCOPIC surgery; CHRONIC kidney failure
- Publication
Alimentary Pharmacology & Therapeutics, 2012, Vol 35, Issue 8, p894
- ISSN
0269-2813
- Publication type
Article
- DOI
10.1111/j.1365-2036.2012.05047.x