Oral versus intravenous proton pump inhibitors in preventing re-bleeding for patients with peptic ulcer bleeding after successful endoscopic therapy

BMC Gastroenterology

Hwai-Jeng Lin²  Shun-Sheng Wu¹  Maw-Soan Soon¹  Wei-Wen Su¹  Chia-Wei Yang¹  Hsu-Heng Yen¹ 

[1] Department of Gastroenterology, Changhua Christian Hospital, Changhua, Taiwan;Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei Medical University, No. 252, Wuxing St, Taipei 11031, Taiwan

关键词: High risk;    Peptic ulcer;    Hemostasis;    Endoscopic therapy;    Proton pump inhibitor;    Peptic ulcer bleeding;   

Others  :  1113046
DOI  :  10.1186/1471-230X-12-66

 received in 2012-02-25, accepted in 2012-05-24,  发布年份 2012

【 摘 要 】

Background

High dose intravenous proton pump inhibitor after endoscopic therapy for peptic ulcer bleeding has been recommended as adjuvant therapy. Whether oral proton pump inhibitor can replace intravenous proton pump inhibitor in this setting is unknown. This study aims to compare the clinical efficacy of oral and intravenous proton pump inhibitor after endoscopic therapy.

Methods

Patients with high-risk bleeding peptic ulcers after successful endoscopic therapy were randomly assigned as oral lansoprazole or intravenous esomeprazole group. Primary outcome of the study was re-bleeding rate within 14 days. Secondary outcome included hospital stay, volume of blood transfusion, surgical intervention and mortality within 1 month.

Results

From April 2010 to Feb 2011, 100 patients were enrolled in this study. The re-bleeding rates were 4% (2/50) in the intravenous group and 4% (2/50) in the oral group. There was no difference between the two groups with regards to the hospital stay, volume of blood transfusion, surgery or mortality rate. The mean duration of hospital stay was 1.8 days in the oral lansoprazole group and 3.9 days in the intravenous esomeprazole group (p > 0.01).

Conclusion

Patients receiving oral proton pump inhibitor have a shorter hospital stay. There is no evidence of a difference in clinical outcomes between oral and intravenous PPI treatment. However, the study was not powered to prove equivalence or non-inferiority. Future studies are still needed.

Trial registration

NCT01123031

【 授权许可】

   
2012 Yen et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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