title: A real world report on intravenous high-dose and non-high-dose proton-pump inhibitors therapy in patients with endoscopically treated high-risk peptic ulcer bleeding.
abstract: Background and Study Aims. The optimal dose of intravenous proton-pump inhibitor (PPI) therapy for the prevention of peptic ulcer (PU) rebleeding remains controversial. This study aimed to understand the real world experiences in prescribing high-dose PPI and non-high-dose PPI for preventing rebleeding after endoscopic treatment of high-risk PU. Patients and Methods. A total of 220 subjects who received high-dose and non-high-dose pantoprazole for confirmed acute PU bleeding that were successfully treated endoscopically were enrolled. They were divided into rebleeding (n = 177) and non-rebleeding groups (n = 43). Randomized matching of the treatment-control group was performed. Patients were randomly selected for non-high-dose and high-dose PPI groups (n = 44 in each group). Results. Univariate analysis showed, significant variables related to rebleeding were female, higher creatinine levels, and higher Rockall scores (≧6). Before case-control matching, the high-dose PPI group had higher creatinine level, higher percentage of shock at presentation, and higher Rockall scores. After randomized treatment-control matching, no statistical differences were observed for rebleeding rates between the high-dose and non-high-dose groups after case-control matching. Conclusion. This study suggests that intravenous high-dose pantoprazole may not be superior to non-high-dose regimen in reducing rebleeding in high-risk peptic ulcer bleeding after successful endoscopic therapy.
authors: Division of Hepato-Gastroenterology, Department of Internal Medicine and Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, 123 Ta-Pei Road, Niaosung Hsiang, Kaohsiung City 833, Taiwan.
authors: Lung-Sheng
authors: LS
authors: Lu
authors: Sheng-Chieh
authors: SC
authors: Lin
authors: Chung-Mou
authors: CM
authors: Kuo
authors: Wei-Chen
authors: WC
authors: Tai
authors: Po-Lin
authors: PL
authors: Tseng
authors: Kuo-Chin
authors: KC
authors: Chang
authors: Chung-Huang
authors: CH
authors: Kuo
authors: Seng-Kee
authors: SK
authors: Chuah