Effect of oral esomeprazole on recurrent bleeding after endoscopic treatment of bleeding peptic ulcers.
BACKGROUND
After endoscopic treatment of bleeding peptic ulcer, a high-dose infusion of omeprazole substantially reduces the risk of recurrent bleeding. The role of oral proton pump inhibitors for these patients is uncertain. The purpose of the present study was to assess whether the use of oral esomeprazole would reduce the frequency of recurrent bleeding after endoscopic treatment of bleeding peptic ulcers.


METHODS
Patients with actively bleeding ulcers or ulcers with non-bleeding visible vessels were treated with an epinephrine injection followed by thermocoagulation. After hemostasis had been achieved, they were randomly assigned in a double-blind fashion to receive esomeprazole (40 mg p.o. twice daily for 3 days) or placebo. The outcome measures studied were recurrent bleeding, blood transfusion requirement, surgery and death.


RESULTS
A total of 70 patients were enrolled, 35 in each group. Bleeding recurred within 30 days in two patients (5.7%) in the esomeprazole group, as compared with three (8.6%) in the placebo group (P = 0.999). Blood transfusion requirement was 2.8 +/- 1.4 units in the esomeprazole group and 2.7 +/- 1.3 units in the placebo group (P = 0.761). Duration of hospitalization was 4.82 +/- 1.8 days in the esomeprazole group and 4.58 +/- 2.7 days in the placebo group (P = 0.792). No patients needed surgery for control of bleeding and no patients died in both groups.


CONCLUSIONS
After successful endoscopic treatment of bleeding peptic ulcer, oral use of esomeprazole might offer no additional benefit on the risk of recurrent bleeding.
Wei
Kou-Liang
KL
Department of Gastroenterology, Chia-Yi Chang Gung Memorial Hospital and Chang Gung University, Chia-Yi, Taiwan.
Tung
Shui-Yi
SY
Sheen
Cheng-Han
CH
Chang
Te-Shen
TS
Lee
I-Lin
IL
Wu
Cheng-Shyong
CS
D000284:Administration, Oral; D000368:Aged; D000897:Anti-Ulcer Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D004311:Double-Blind Method; D016099:Endoscopy, Gastrointestinal; D064098:Esomeprazole / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000517:prevention & control* / Q000601:surgery*; D012008:Recurrence; D012307:Risk Factors; D016896:Treatment Outcome
D000897:Anti-Ulcer Agents; D064098:Esomeprazole