Comparison of a Hemostatic Powder and Standard Treatment in the Control of Active Bleeding From Upper Nonvariceal Lesions
Authors: Rapat Pittayanon, James Y.W. Lau
Journal: Annals of Internal Medicine (2022)

LettersApril 2022Comparison of a Hemostatic Powder and Standard Treatment in the Control of Active Bleeding From Upper Nonvariceal LesionsRapat Pittayanon, MD and James Y.W. Lau, MDRapat Pittayanon, MDDivision of Gastroenterology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, ThailandSearch for more papers by this author and James Y.W. Lau, MDInstitute of Digestive Disease, The Chinese University of Hong Kong, Hong KongSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L22-0069 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE: We thank Drs. Agarwal and Chauhan for their comments. Our randomized controlled trial (RCT) was of a 1-sided, noninferiority design. The risk difference in the control of bleeding within 30 days was 8.7 percentage points (TC-325, 90.1%; standard treatment, 81.4%). Furthermore, the 1-sided 95% CI was 0.95 percentage point in favor of hemostatic powder, which was within our prespecified noninferiority margin of 10% (that is, hemostatic powder would be no more than 10% worse in controlling bleeding). We therefore concluded that TC-325 was not inferior to standard treatment in the control of bleeding from nonvariceal causes.The higher ...References1. Sung JJ, Barkun A, Kuipers EJ, 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. Lau JYW, Pittayanon R, Wong KT, et al. Prophylactic angiographic embolisation after endoscopic control of bleeding to high-risk peptic ulcers: a randomised controlled trial. Gut. 2019;68:796-803. [PMID: 29802172] doi:10.1136/gutjnl-2018-316074 CrossrefMedlineGoogle Scholar3. Over-the-scope Clip Versus Through-the-scope Clip for Endoscopic Hemostasis of High Risk Bleeding Peptic Ulcers (OTSCvsTTS). ClinicalTrials.gov: NCT03551262. Accessed at https://clinicaltrials.gov/ct2/show/NCT03551262 on 7 February 2022. Google Scholar4. The Use of Over-the-scope-clip for Prevention of Rebleeding in High Risk Peptic Ulcers. ClinicalTrials.gov: NCT03160911. Accessed at https://clinicaltrials.gov/ct2/show/NCT03160911 on 7 February 2022. Google Scholar Author, Article, and Disclosure InformationAffiliations: Division of Gastroenterology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, ThailandInstitute of Digestive Disease, The Chinese University of Hong Kong, Hong KongDisclosures: Authors have reported no disclosures of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M21-0975. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoComparison of a Hemostatic Powder and Standard Treatment in the Control of Active Bleeding From Upper Nonvariceal Lesions James Y.W. Lau , Rapat Pittayanon , Andrew Kwek , Raymond S. Tang , Heyson Chan , Rungsun Rerknimitr , June Lee , Tiing Leong Ang , Bing-Yee Suen , Yuan-yuan Yu , Francis K.L. Chan , and Joseph J.Y. Sung Metrics April 2022Volume 175, Issue 4Page: W45-W46KeywordsEndoscopyEsophagogastroduodenoscopyHemostasis ePublished: 19 April 2022 Issue Published: April 2022 Copyright & PermissionsCopyright © 2022 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...