PWE-032 Hemospray for acute upper gastrointestinal bleeding – a single centre experience

Widlak, MM; Wijesinghe, Haren; Siau, Keith; Molitor, Timothy; Quraishi, MN; Armstrong, Matthew; Troth, Thomas; Iqbal, Tariq; Goh, Jason

doi:10.1136/gutjnl-2015-309861.481

Cited by 1 publication

(1 citation statement)

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“…Overall, 59 studies were included (n = 3417 patients). Hemospray (TC-325) was the sole intervention in 44 studies 15 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 , EndoClot in five 65 66 67 68 69 , PuraStat in four 70 71 72 73 , Nexpowder in three 74 75 76 and CEGP-003 77 in one. In addition, two studies included both Hemospray and EndoClot 78 79 .…”

Section: Resultsmentioning

confidence: 99%

Topical hemostatic agents in the management of upper gastrointestinal bleeding: a meta-analysis

et al. 2022

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Background Novel topical hemostatic agents have shown promising results in treating patients with non-variceal upper gastrointestinal bleeding (NVUGIB). However, data are limited even in published meta-analyses as to their role, especially compared to conventional endoscopic approaches. The aim of this study was to perform a highly comprehensive systematic review assessing the effectiveness of topical hemostatic agents in UGIB in different clinical settings. Methods We performed a literature search of OVID MEDLINE, EMBASE, and ISI Web of Knowledge databases through September 2021. Studies assessing the efficacy of topical hemostatic agents in UGIB were included. Primary outcomes were immediate hemostasis and overall rebleeding. Results A total of 980 citations were identified and 59 studies with a total of 3,417 patients were included in the analysis. Immediate hemostasis was achieved in 93% (91%; 94%), with similar results according to etiology (NVUGIB vs. variceal), topical agent used, or treatment strategy (primary vs. rescue). The overall rebleeding rate was 18% (15%; 21%) with the majority of rebleeds occurring in the first 7 days. Amongst comparative studies, topical agents achieved immediate hemostasis more often than standard endoscopic modalities (OR 3.94 (1.73; 8.96)), with non-different overall rebleeding risks (OR 1.06 (0.65; 1.74)). Adverse events occurred in 2% (1%; 3%). Study quality was overall low to very low. Conclusions Topical hemostatic agents are effective and safe in the management of UGIB with favorable outcomes when compared to conventional endoscopic modalities across a variety of bleeding etiologies. This is especially true in novel subgroup analyses that assessed immediate hemostasis and rebleeding amongst RCTs and in malignant bleeding. Due to methodological limitations of available data, additional studies are needed to more confidently ascertain their effectiveness in patients with UGIB.

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