Meta-analysis of 5 first-line RCTs: OTSC® effectively reduces rebleeding in NVUGIB

Meta-analysis of 5 RCTs on OTSC® for the first-line treatment of NVUGIB shows that OTSC® has significantly lower 30-day rebleeding rate compared to standard endoscopic therapy

Key findings

• The primary endpoint of further bleeding (persistent or recurrent) was significantly lower with OTSC® compared to standard endoscopic therapy (RR=0.33 [95% CI 0.20-0.54])
• 30-day rebleeding was significantly reduced with OTSC® (RR=0.38 [95% CI: 0.21-0.70])
• Authors conclude that OTSC® is an effective primary hemostatic modality , resulting in significantly lower risk of further bleeding at 30 days

Study details

• Literature search was performed up to April 2024
• Meta-analysis included 5 RCTs, all assessing OTSC® for the primary treatment of NVUGIB (non-variceal upper GI bleeding)
• Primary endpoint “further bleeding” was the composite outcome of persistent bleeding at the index endoscopy and further bleeding at 30 days.
• Standard endoscopic therapy included TTS clips and/or thermal therapy used in combination with injection therapy.

Alali AA, Almadi MA, Martel M, Barkun AN. The use of cap-mounted clips as a primary hemostatic modality in nonvariceal upper gastrointestinal bleeding: A systematic review and meta-analysis of randomized trials. Saudi J Gastroenterol. 2024;30(4):200–9. Doi: 10.4103/sjg.sjg_86_24