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Dr Angel Lanas and colleagues assessed clinical outcomes in patients treated with proton pump inhibitors after endoscopic hemostasis in routine clinical care, and compared these outcomes to those seen in a randomized controlled trial of i.v. esomeprazole. Patients with peptic ulcer bleeding and endoscopic stigmata of recent hemorrhage, who were treated with i.v. esomeprazole or pantoprazole 120 mg/day following therapeutic endoscopy, were identified from 12 hospitals in Spain. reported that outcomes assessed included further bleeding, all-cause mortality and surgery. The results were compared to those of the randomized controlled trial Results. The team of doctors noted that overall, 9% of patients experienced further bleeding within 72 hours following initial endoscopy, 14% of patients had further bleeding within 30 days, and 3% of patients died within 30 days.  | | 9% of patients experienced further bleeding within 72 hours following initial endoscopy | | Scandinavian Journal of Gastroenterology |
In the randomized controlled trial, the rate of rebleeding within 72 hours was significantly lower in the esomeprazole arm than in the placebo arm. The research team found that the further bleeding rate in patients treated with esomeprazole in routine clinical practice was between these 2 values. Similar results were seen with the other outcomes studied. Dr Lana's team concludes, "The proportion of patients treated with i.v. esomeprazole in routine clinical practice who experienced further bleeding following endoscopic treatment for peptic ulcer bleeding was between the rates observed in the esomeprazole group, and the placebo group in the randomized controlled trial."
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