Peptic Ulcer Bleeding Clinical Trial
Official title:
A Double Blind Study Comparing Low Dose and High Dose IV Esomeprazole After Successful Endoscopic Therapy in Patients With Peptic Ulcer Bleeding
The investigators used two different doses of esomeprazole (40 mg IV q.d. and 40 mg IV q6h
for three days followed by esomeprazole 40 mg q.d. orally in two groups) after successful
endoscopic therapy with heat probe therapy or hemoclip placement.
The goal of this study is to assess the outcomes of two different regimens of low vs. high
dose of intravenous esomeprazole after endoscopic therapy in patients with peptic ulcer
bleeding.
A bleeding peptic ulcer remains a serious medical problem with significant morbidity and
mortality. Endoscopic therapy significantly reduces further bleeding, surgery, and mortality
in patients receiving intravenous Proton Pump Inhibitor (PPIļ¼and is now recommended as the
first hemostatic modality for these patients. In the past few years, adjuvant use of a
high-dose proton pump inhibitor (PPI) after endoscopic therapy has been endorsed in some
studies, including two consensus statements and two meta-analysis. To sustain a high
intragastric pH, a high dose of omeprazole has been used in previous studies concerning
high-risk peptic ulcer bleeding. However, in one recent published metaanalysis found that low
dose PPI may be as effective as high dose PPI in preventing further bleeding in high-risk
patients. Therefore, one double blind study is needed clarify this puzzle.
We used two different doses of esomeprazole (40 mg IV q.d. and 40 mg IV q6h for three days
followed by esomeprazole 40 mg q.d. orally in two groups) after successful endoscopic therapy
with heat probe therapy or hemoclip placement.
The goal of this study is to assess the outcomes of two different regimens of low vs. high
dose of intravenous esomeprazole after endoscopic therapy in patients with peptic ulcer
bleeding.
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