Missed Opportunities in the Trial on Proton-Pump Inhibitor Therapy in Bleeding Peptic Ulcers
Authors: Hwai Jeng Lin, Yao Chun Hsu
Journal: Annals of Internal Medicine (2009)

Letters20 October 2009Missed Opportunities in the Trial on Proton-Pump Inhibitor Therapy in Bleeding Peptic UlcersHwai-Jeng Lin, MD and Yao-Chun Hsu, MD, MScHwai-Jeng Lin, MDFrom Changhua Christian Hospital, Changhua 500, Taiwan, and Lotung Poh-Ai Hospital, Ilan 265, Taiwan.Search for more papers by this author and Yao-Chun Hsu, MD, MScFrom Changhua Christian Hospital, Changhua 500, Taiwan, and Lotung Poh-Ai Hospital, Ilan 265, Taiwan.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-151-8-200910200-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We would like to comment on the article by Sung and colleagues (1), which reaffirmed the clinical effectiveness of infusional esomeprazole as an adjuvant pharmacotherapy for patients at high risk for bleeding peptic ulcers. First, it is extraordinary that the rebleeding and mortality rates in the placebo recipients were 13.6% and 2.1%, respectively, which are noticeably lower than those in most previous reports. A recent Cochrane meta-analysis (2) revealed a rebleeding rate of 19.2% and a mortality rate of 4.9% in the patients with bleeding ulcers who received placebo. Unfortunately, Sung and colleagues did not explain the ...References1. Sung JJ, Barkun A, Kuipers EJ, Mössner J, Jensen DM, Stuart R, et al; Peptic Ulcer Bleed Study Group. Intravenous esomeprazole for prevention of recurrent peptic ulcer bleeding: a randomized trial. Ann Intern Med. 2009;150:455-64. [PMID: 19221370] LinkGoogle Scholar2. Leontiadis GI, Sharma VK, Howden CW. Proton pump inhibitor therapy for peptic ulcer bleeding: Cochrane collaboration meta-analysis of randomized controlled trials. Mayo Clin Proc. 2007;82:286-96. [PMID: 17352364] CrossrefMedlineGoogle Scholar3. Lau JY, Leung WK, Wu JC, Chan FK, Wong VW, Chiu PW, et al. Omeprazole before endoscopy in patients with gastrointestinal bleeding. N Engl J Med. 2007;356:1631-40. [PMID: 17442905] CrossrefMedlineGoogle Scholar4. Lin HJ, Lo WC, Lee FY, Perng CL, Tseng GY. A prospective randomized comparative trial showing that omeprazole prevents rebleeding in patients with bleeding peptic ulcer after successful endoscopic therapy. Arch Intern Med. 1998;158:54-8. [PMID: 9437379] CrossrefMedlineGoogle Scholar5. Leontiadis GI, Sharma VK, Howden CW. Systematic review and meta-analysis: enhanced efficacy of proton-pump inhibitor therapy for peptic ulcer bleeding in Asia—a post hoc analysis from the Cochrane Collaboration. Aliment Pharmacol Ther. 2005;21:1055-61. [PMID: 15854166] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Hwai-Jeng Lin, MD; Yao-Chun Hsu, MD, MScAffiliations: From Changhua Christian Hospital, Changhua 500, Taiwan, and Lotung Poh-Ai Hospital, Ilan 265, Taiwan.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoIntravenous Esomeprazole for Prevention of Recurrent Peptic Ulcer Bleeding Joseph J.Y. Sung , Alan Barkun , Ernst J. Kuipers , Joachim Mössner , Dennis M. Jensen , Robert Stuart , James Y. Lau , Henrik Ahlbom , Jan Kilhamn , and Tore Lind , for the Peptic Ulcer Bleed Study Group* Missed Opportunities in the Trial on Proton-Pump Inhibitor Therapy in Bleeding Peptic Ulcers Alejandro Piscoya Missed Opportunities in the Trial on Proton-Pump Inhibitor Therapy in Bleeding Peptic Ulcers Joseph J.Y. Sung , Alan Barkun , and Ernst J. Kuipers Missed Opportunities in the Trial on Proton-Pump Inhibitor Therapy in Bleeding Peptic Ulcers Vivian Yih and Aaron Tejani Metrics Cited byEsomeprazole for the treatment of peptic ulcer bleeding 20 October 2009Volume 151, Issue 8 Page: 589 Keywords Death rates Endoscopy Epinephrine injection Hemorrhage Hemostasis Hemostatics Oral administration Peptic ulcers Proton pump inhibitors Ulcers ePublished: 20 October 2009 Issue Published: 20 October 2009 Copyright & PermissionsCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...