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CHICAGO — Patients with bleeding peptic ulcers have quicker resolution of bleeding stigmata and less need for endoscopic therapy if they receive high-dose intravenous omeprazole before endoscopy, James Lau, M.D., reported at the annual Digestive Disease Week.
Dr. Lau, director of the endoscopy center at Prince of Wales Hospital in Hong Kong, presented the results of a double-blind, placebo-controlled trial of omeprazole in 369 patients with overt signs of upper GI bleeding who were scheduled for endoscopy.
Between February and November 2004, Dr. Lau and his coinvestigators randomized 179 of the patients to receive an 80-mg IV bolus of omeprazole and 8 mg/h before endoscopy (mean hours of infusion 14.9). The other 190 patients received a placebo before the procedure.
At endoscopy, a bleeding peptic ulcer was the most common cause of upper GI bleeding found. Bleeding ulcers were documented in 110 patients who had received high-dose omeprazole (61%) and 112 patients who had received placebo (59%) before endoscopy.
The primary outcome measured was the need for endoscopic treatment, which consisted of epinephrine injection and heater probe thermocoagulation for actively bleeding ulcers or ulcers with nonbleeding visible vessels or clots. Significantly fewer patients with bleeding ulcers in the omeprazole group needed endoscopic treatment, compared with the placebo group (19 of 110 patients vs. 40 of 112), he said.
In this subgroup, only 20 (18%) of the 110 patients who received omeprazole had endoscopic stigmata of bleeding, whereas 41 (37%) of the 112 patients who received placebo had bleeding stigmata. The difference was statistically significant.
Preemptive use of high-dose omeprazole appears to have not only hemostatic effects but also healing effects, Dr. Lau said. Data showed significantly more clean-base ulcers at index endoscopy in patients assigned to the proton pump inhibitor than in those on placebo (74 vs. 50, respectively).
CHICAGO — Patients with bleeding peptic ulcers have quicker resolution of bleeding stigmata and less need for endoscopic therapy if they receive high-dose intravenous omeprazole before endoscopy, James Lau, M.D., reported at the annual Digestive Disease Week.
Dr. Lau, director of the endoscopy center at Prince of Wales Hospital in Hong Kong, presented the results of a double-blind, placebo-controlled trial of omeprazole in 369 patients with overt signs of upper GI bleeding who were scheduled for endoscopy.
Between February and November 2004, Dr. Lau and his coinvestigators randomized 179 of the patients to receive an 80-mg IV bolus of omeprazole and 8 mg/h before endoscopy (mean hours of infusion 14.9). The other 190 patients received a placebo before the procedure.
At endoscopy, a bleeding peptic ulcer was the most common cause of upper GI bleeding found. Bleeding ulcers were documented in 110 patients who had received high-dose omeprazole (61%) and 112 patients who had received placebo (59%) before endoscopy.
The primary outcome measured was the need for endoscopic treatment, which consisted of epinephrine injection and heater probe thermocoagulation for actively bleeding ulcers or ulcers with nonbleeding visible vessels or clots. Significantly fewer patients with bleeding ulcers in the omeprazole group needed endoscopic treatment, compared with the placebo group (19 of 110 patients vs. 40 of 112), he said.
In this subgroup, only 20 (18%) of the 110 patients who received omeprazole had endoscopic stigmata of bleeding, whereas 41 (37%) of the 112 patients who received placebo had bleeding stigmata. The difference was statistically significant.
Preemptive use of high-dose omeprazole appears to have not only hemostatic effects but also healing effects, Dr. Lau said. Data showed significantly more clean-base ulcers at index endoscopy in patients assigned to the proton pump inhibitor than in those on placebo (74 vs. 50, respectively).
CHICAGO — Patients with bleeding peptic ulcers have quicker resolution of bleeding stigmata and less need for endoscopic therapy if they receive high-dose intravenous omeprazole before endoscopy, James Lau, M.D., reported at the annual Digestive Disease Week.
Dr. Lau, director of the endoscopy center at Prince of Wales Hospital in Hong Kong, presented the results of a double-blind, placebo-controlled trial of omeprazole in 369 patients with overt signs of upper GI bleeding who were scheduled for endoscopy.
Between February and November 2004, Dr. Lau and his coinvestigators randomized 179 of the patients to receive an 80-mg IV bolus of omeprazole and 8 mg/h before endoscopy (mean hours of infusion 14.9). The other 190 patients received a placebo before the procedure.
At endoscopy, a bleeding peptic ulcer was the most common cause of upper GI bleeding found. Bleeding ulcers were documented in 110 patients who had received high-dose omeprazole (61%) and 112 patients who had received placebo (59%) before endoscopy.
The primary outcome measured was the need for endoscopic treatment, which consisted of epinephrine injection and heater probe thermocoagulation for actively bleeding ulcers or ulcers with nonbleeding visible vessels or clots. Significantly fewer patients with bleeding ulcers in the omeprazole group needed endoscopic treatment, compared with the placebo group (19 of 110 patients vs. 40 of 112), he said.
In this subgroup, only 20 (18%) of the 110 patients who received omeprazole had endoscopic stigmata of bleeding, whereas 41 (37%) of the 112 patients who received placebo had bleeding stigmata. The difference was statistically significant.
Preemptive use of high-dose omeprazole appears to have not only hemostatic effects but also healing effects, Dr. Lau said. Data showed significantly more clean-base ulcers at index endoscopy in patients assigned to the proton pump inhibitor than in those on placebo (74 vs. 50, respectively).