title: Intravenous pantoprazole versus ranitidine for prevention of rebleeding after endoscopic hemostasis of bleeding peptic ulcers.
abstract: OBJECTIVE
  The role of intravenous pantoprazole in treatment of patients with high-risk bleeding peptic ulcers following endoscopic hemostasis remains uncertain. We therefore conducted the pilot prospective randomized study to assess whether intravenous pantoprazole could improve the efficacy of H(2)-antagonist as an adjunct treatment following endoscopic injection therapy for bleeding ulcers.
  
  
  METHODS
  Patients with active bleeding ulcers or ulcers with major signs of recent bleeding were treated with distilled water injection. After hemostasis was achieved, they were randomly assigned to receive intravenous pantoprazole or ranitidine.
  
  
  RESULTS
  One hundred and two patients were enrolled in this prospective trial. Bleeding recurred in 2 patients (4%) in the pantoprazole group (n = 52), as compared with 8 (16%) in the ranitidine group (n = 50). The rebleeding rate was significantly lower in the pantoprazole group (P = 0.04). There were no statistically significant differences between the groups with regard to the need for emergency surgery (0% vs 2%), transfusion requirements (4.9+/-5.9 vs 5.7+/-6.8 units), hospital days (5.9+/-3.2 vs 7.5+/-5.0 d) or mortality (2% vs 2%).
  
  
  CONCLUSIONS
  Pantoprozole is superior to ranitidine as an adjunct treatment to endoscopic injection therapy in high-risk bleeding ulcers.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386, Ta-Chung 1st Road, Kaohsiung 813, Taiwan, China.
authors.forename: Ping-I
authors.initials: PI
authors.lastname: Hsu
authors.forename: Gin-Ho
authors.initials: GH
authors.lastname: Lo
authors.forename: Ching-Chu
authors.initials: CC
authors.lastname: Lo
authors.forename: Chiun-Ku
authors.initials: CK
authors.lastname: Lin
authors.forename: Hoi-Hung
authors.initials: HH
authors.lastname: Chan
authors.forename: Chung-Jen
authors.initials: CJ
authors.lastname: Wu
authors.forename: Chang-Bih
authors.initials: CB
authors.lastname: Shie
authors.forename: Pei-Min
authors.initials: PM
authors.lastname: Tsai
authors.forename: Deng-Chyang
authors.initials: DC
authors.lastname: Wu
authors.forename: Wen-Ming
authors.initials: WM
authors.lastname: Wang
authors.forename: Kwok-Hung
authors.initials: KH
authors.lastname: Lai
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000897:Anti-Ulcer Agents / Q000008:administration & dosage*; D001562:Benzimidazoles / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D005260:Female; D016558:Hemostasis, Endoscopic; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D000077402:Pantoprazole; D010438:Peptic Ulcer Hemorrhage / Q000188:drug therapy*; D010865:Pilot Projects; D011446:Prospective Studies; D011899:Ranitidine / Q000008:administration & dosage*; D055502:Secondary Prevention; D013454:Sulfoxides / Q000008:administration & dosage*
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D001562:Benzimidazoles; D013454:Sulfoxides; D011899:Ranitidine; D000077402:Pantoprazole; D009853:Omeprazole