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Double oral dose esomeprazole reduced peptic ulcer bleeding after 3-day infusion
Recurrent peptic ulcer bleeding in high-risk patients who had received esomeprazole infusion was reduced after patients received double oral esomeprazole therapy, according to recent trial results.
In a prospective study, investigators recruited and analyzed 276 patients with peptic ulcer bleeding. All patients had achieved endoscopic hemostasis, and all had received a 3-day esomeprazole infusion. High-risk patients with Rockall scores of 6 or greater were randomly assigned to a 40-mg, twice-daily oral dose esomeprazole group (n=93) or a 40-mg, once-daily oral dose esomeprazole group (n=94) for 11 days.
Patients with Rockall scores of less than 6 served as controls (n=89), receiving 40 mg oral esomeprazole once daily for 11 days. All patients then received once-daily 40 mg oral esomeprazole for an additional 2 weeks through the 28-day span of research.
The primary endpoint was recurrence of peptic ulcer bleeding during the study period.
Among patients with Rockall scores of at least 6, risk for rebleeding between days 4 and 28 was reduced in the oral double-dose group (10.8% vs. 28.7%; P=.002). Length of hospitalization and units of blood transfused were lower among patients with Rockall scores of less than 6 compared with those with greater scores (P=.03).
“The study confirms that the Rockall score is a good risk predictor of peptic ulcer rebleeding and guides the indication of oral double-dose proton pump inhibitors after infusion to reduce peptic ulcer rebleeding in high-risk patients,” the investigators wrote.
Disclosure: The researchers report no relevant financial disclosures.