93 % primary hemostasis was achieved with primary OTSC therapy (288 patients), 91 % with rescue OTSC therapy (187 patients)
Ofosu A et al., The Brooklyn Hospital Center, Clinical Affiliate of the Mount Sinai Hospital, Brooklyn, NY, USA, performed a systematic review and meta-analysis to evaluate primary hemostasis rates and re-bleeding rates of the OTSC for primary therapy and rescue endoscopic interventions in patients with non-variceal gastro-intestinal bleeding (NVGIB).
A total of 16 studies which involved 475 patients were included. 288 patients were treated with OTSC as primary therapy while 187 patients were treated with OTSC as rescue therapy. Primary hemostasis rate achieved with primary endoscopic therapy with OTSC was 0.93 (95 % CI: 0.89 – 0.96). Similarly, primary hemostasis rate achieved with rescue endoscopic therapy with OTSC was 0.91 (95 % CI: 0.84 – 0.95). Re-bleeding rates after primary endoscopic therapy with OTSC was 0.21 (95 % CI:0.08 – 0.43) and 0.25 (95 % CI:0.17 – 0.34) with rescue therapy. There was a decreased risk of re-bleeding in patients treated with OTSC as primary therapy versus rescue therapy RR = 0.52 (95 % CI: 0.31-0.89).
The authors concluded that this meta-analysis demonstrates success on the use of OTSC as primary and rescue therapy in the management of NVGIB. Further studies are however needed.
Over-the-scope-clips as primary and rescue therapy for non-variceal gastrointestinal bleeding: a systematic review and meta-analysis
Ofosu A, Ramai D, John F, Barakat M, Sunkara T, Sharma S, Gaduputi V, Adler DG, Reddy M.
Minerva Gastroenterol Dietol. 2018 Nov 7. doi: 10.23736/S1121-421X.18.02513-8. [Epub ahead of print]