PMID- 19086953
OWN - NLM
STAT- MEDLINE
DCOM- 20090108
LR  - 20100420
IS  - 1572-0241 (Electronic)
IS  - 0002-9270 (Linking)
VI  - 103
IP  - 12
DP  - 2008 Dec
TI  - High- versus low-dose proton pump inhibitors after endoscopic hemostasis in 
      patients with peptic ulcer bleeding: a multicentre, randomized study.
PG  - 3011-8
LID - 10.1111/j.1572-0241.2008.02149.x [doi]
AB  - BACKGROUND: The most effective schedule of proton pump inhibitor (PPI) 
      administration following endoscopic hemostasis of bleeding ulcers remains 
      uncertain. METHODS: Patients with actively bleeding ulcers and those with 
      nonbleeding visible vessel or adherent clot were treated with epinephrine 
      injection and/or thermal coagulation, and randomized to receive intravenous PPIs 
      according to an intensive regimen (80 mg bolus followed by 8 mg/h as continuous 
      infusion for 72 h) or a standard regimen (40 mg bolus daily followed by saline 
      infusion for 72 h). After the infusion, all patients were given 20 mg PPI twice 
      daily orally. The primary end point was the in-hospital rebleeding rate, as 
      ascertained at the repeat endoscopy. RESULTS: Bleeding recurred in 28 of 238 
      patients (11.8%) receiving the intensive regimen, and in 19 of 236 (8.1%) 
      patients receiving the standard regimen (P= 0.18). Most rebleeding episodes 
      occurred during the initial 72-h infusion: 18 (7.6%) and 19 events (8.1%) in the 
      intensive and standard groups, respectively (P= 0.32). Mean units of blood 
      transfused were 1.7 +/- 2.1 in the intensive and 1.5 +/- 2.1 in the standard 
      regimen group (P= 0.34). The duration of hospital stay was <5 days for 88 (37.0%) 
      and 111 patients (47.0%) in the intensive and standard groups (P= 0.03). There 
      were fewer surgical interventions in the standard versus intensive regimen (1 vs 
      3). Five patients in each treatment group died. CONCLUSIONS: Following endoscopic 
      hemostasis of bleeding ulcers, standard-dose PPIs infusion was as effective as a 
      high-dose regimen in reducing the risk of recurrent bleeding. (ClinicalTrials.gov 
      number, NCT00374101).
FAU - Andriulli, Angelo
AU  - Andriulli A
AD  - Casa Sollievo della Sofferenza Hospital, IRCCS, San Giovanni, Rotondo, Italy.
FAU - Loperfido, Silvano
AU  - Loperfido S
FAU - Focareta, Rosaria
AU  - Focareta R
FAU - Leo, Pietro
AU  - Leo P
FAU - Fornari, Fabio
AU  - Fornari F
FAU - Garripoli, Antonietta
AU  - Garripoli A
FAU - Tonti, Paolo
AU  - Tonti P
FAU - Peyre, Sergio
AU  - Peyre S
FAU - Spadaccini, Antonio
AU  - Spadaccini A
FAU - Marmo, Riccardo
AU  - Marmo R
FAU - Merla, Antonio
AU  - Merla A
FAU - Caroli, Alessandro
AU  - Caroli A
FAU - Forte, Gian Battista
AU  - Forte GB
FAU - Belmonte, Angelo
AU  - Belmonte A
FAU - Aragona, Giovanni
AU  - Aragona G
FAU - Imperiali, Gianni
AU  - Imperiali G
FAU - Forte, Fabrizio
AU  - Forte F
FAU - Monica, Fabio
AU  - Monica F
FAU - Caruso, Nazario
AU  - Caruso N
FAU - Perri, Francesco
AU  - Perri F
LA  - eng
SI  - ClinicalTrials.gov/NCT00374101
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - Am J Gastroenterol
JT  - The American journal of gastroenterology
JID - 0421030
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
CIN - Am J Gastroenterol. 2008 Dec;103(12):3019-21. PMID: 18853974
CIN - Am J Gastroenterol. 2009 Jun;104(6):1595; author reply 1595-6. PMID: 19491877
CIN - Am J Gastroenterol. 2009 Aug;104(8):2120-1. PMID: 19661947
CIN - Endoscopy. 2010 Jan;42(1):53-7. PMID: 20066591
MH  - Aged
MH  - Double-Blind Method
MH  - Female
MH  - *Hemostasis, Endoscopic
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Peptic Ulcer Hemorrhage/*therapy
MH  - Proton Pump Inhibitors/*administration & dosage
MH  - Recurrence
EDAT- 2008/12/18 09:00
MHDA- 2009/01/09 09:00
CRDT- 2008/12/18 09:00
PHST- 2008/12/18 09:00 [entrez]
PHST- 2008/12/18 09:00 [pubmed]
PHST- 2009/01/09 09:00 [medline]
AID - AJG2149 [pii]
AID - 10.1111/j.1572-0241.2008.02149.x [doi]
PST - ppublish
SO  - Am J Gastroenterol. 2008 Dec;103(12):3011-8. doi: 
      10.1111/j.1572-0241.2008.02149.x.