Oral esomeprazole vs injectable omeprazole for the prevention of hemorrhage after endoscopic submucosal dissection

World J Gastrointest Endosc. 2017 Oct 16;9(10):514-520. doi: 10.4253/wjge.v9.i10.514.

Abstract

Aim: To evaluate the effectiveness of oral esomeprazole (EPZ) vs injectable omeprazole (OPZ) therapy to prevent hemorrhage after endoscopic submucosal dissection (ESD).

Methods: A case-control study was conducted using a quasi-randomized analysis with propensity score matching. A total of 258 patients were enrolled in this study. Patients were treated with either oral EPZ or injectable OPZ. The endpoint was the incidence of hemorrhage after ESD.

Results: Data of 71 subjects treated with oral EPZ and 172 subjects treated with injectable OPZ were analyzed. Analysis of 65 matched samples revealed no difference in the incidence of hemorrhage after ESD between the oral EPZ and injectable OPZ groups (OR = 0.89, 95%CI: 0.35-2.27, P ≥ 0.99).

Conclusion: We conclude that oral EPZ therapy is a useful alternative to injectable PPI therapy for the prevention of hemorrhage after ESD.

Keywords: Endoscopic submucosal dissection; Hemorrhage; Proton pump inhibitors.