https://gastroenterology.acponline.org/archives/2023/03/24/10.htm

Over-the-scope clips may be better initial treatment than standard hemostatic treatment in patients with nonvariceal upper GI bleeding

In a randomized controlled trial of 190 adults, 30-day probability of further bleeding was significantly lower in patients who received over-the-scope clips than in those who received standard endoscopic hemostatic treatment.


Over-the-scope clips may be better than standard endoscopic hemostatic treatment for initial control of bleeding from nonvariceal upper GI causes, a randomized controlled trial found.

The trial included 190 adult patients with active bleeding or a nonbleeding visible vessel from a nonvariceal cause on upper GI endoscopy at university teaching hospitals in Hong Kong, China, and Australia. Ninety-seven received standard hemostatic treatment, and 93 received over-the-scope clips. The primary outcome, 30-day probability of further bleeding, was 14.6% in the standard treatment group and 3.2% in the over-the-scope clip group (risk difference, 11.4 percentage points [95% CI, 3.3 to 20.0 percentage points]; P=0.006). Limitations of the trial included the fact that clinicians were not blinded to treatment and the option of crossover treatment. The study and an accompanying editorial were published March 7 by Annals of Internal Medicine.