Academic Journal
Low-dose PPI to prevent bleeding after ESD: A multicenter randomized controlled study
| العنوان: | Low-dose PPI to prevent bleeding after ESD: A multicenter randomized controlled study |
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| المؤلفون: | Li Yang, Jian Qi, Weiqing Chen, Qinghong Guo, Rui Xie, Zhifeng Zhao, Shanyu Qin, Aiming Liu, Mingming Den, Chaoqiang Fan, Jianyin Bai, Hui Lin, Hong Guo, Shiming Yang |
| المصدر: | Biomedicine & Pharmacotherapy, Vol 136, Iss , Pp 111251- (2021) |
| بيانات النشر: | Elsevier |
| سنة النشر: | 2021 |
| المجموعة: | Directory of Open Access Journals: DOAJ Articles |
| مصطلحات موضوعية: | Proton pump inhibitor (PPI), Endoscopic submucosal dissection (ESD), Post ESD bleeding, ESD-related ulcer, Randomized, controlled clinical trial, Therapeutics. Pharmacology, RM1-950 |
| الوصف: | Background: Although proton pump inhibitors (PPIs) are widely used in the prevention of gastric bleeding caused by endoscopic submucosal dissection (ESD), there is no consensus on the optimal regimen for these patients. Therefore, we aim to investigate whether intermittent use of low-dose PPI is sufficient to prevent post-ESD bleeding. Methods: This multicenter, non-inferiority, randomized controlled trial was conducted at 9 hospitals in China. Consecutive eligible patients with a diagnosis of gastric mucosal lesions after ESD treatment were randomly assigned (1:1) to receive either intermittent low-dose or continuous high-dose PPIs treatment. After three days, all patients administered orally esomeprazole 40 mg once a day for 8 weeks. The primary endpoint was post-ESD bleeding within 7 days. Analysis was done according to the intention-to-treat principle with the non-inferiority margin (Δ) of 5%. Results: 526 consecutive patients were assessed for eligibility from 30 September 2017 to 30 July 2019, of whom 414 were randomly assigned to low-dose (n = 209) or high-dose (n = 205) esomeprazole treatment group without dropouts within7 days. The total post-ESD bleeding is occurred in 13 (6.2 %, 95 % CI 3.3–9.6) of 209 within 7 days in the intermittent low-dose group, and 12 (5.9 %, 95 % CI 2.9–9.3) of 205 in the continuous high-dose group. The absolute risk reduction (ARR) was 0.4 % (−4.2, 4.9). One month after ESD, There are 44 patients (21.1 %, 95 % CI 15.8, 26.8) and 39 patients (19.0 % 95 % CI 13.7, 24.4) in scar stage respectively in low-dose group and high-dose group (P = 0.875).The hospital costs in the low-dose PPI group was lower than high -dose group (P = 0.005). Conclusion: The intermittent use of low-dose PPIs is sufficient to prevent post-ESD bleeding. It might be applied in clinical practice to prevent post-ESD bleeding and reduce the costs related to PPIs. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| ردمك: | 978-0-7533-3222-1 0-7533-3222-1 |
| تدمد: | 0753-3322 |
| Relation: | http://www.sciencedirect.com/science/article/pii/S0753332221000366; https://doaj.org/toc/0753-3322; https://doaj.org/article/7bdcbb7e159c4c4face6951ebc622e38 |
| DOI: | 10.1016/j.biopha.2021.111251 |
| الاتاحة: | https://doi.org/10.1016/j.biopha.2021.111251 https://doaj.org/article/7bdcbb7e159c4c4face6951ebc622e38 |
| رقم الانضمام: | edsbas.37D796E3 |
| قاعدة البيانات: | BASE |
Full Text Finder | ردمك: | 9780753332221 0753332221 |
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| تدمد: | 07533322 |
| DOI: | 10.1016/j.biopha.2021.111251 |