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Letter
Over-the-scope clips versus standard therapy in upper gastrointestinal bleeding
  1. Benjamin Meier1,
  2. Arthur Schmidt2,
  3. Karel Caca1
  1. 1 Gastroenterology, Klinikum Ludwigsburg, Ludwigsburg, Germany
  2. 2 Department Innere Medizin, Klinik für Innere Medizin II, Universitätsklinikum Freiburg, Freiburg, Germany
  1. Correspondence to Professor Karel Caca, Gastroenterology, Klinikum Ludwigsburg, Ludwigsburg 71640, Germany; karel.caca{at}rkh-kliniken.de

https://doi.org/10.1136/gutjnl-2022-329296

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    We read with high interest the randomised controlled trial (RCT) of Chan et al investigating over-the-scope clips (OTSC) versus standard therapy for the prevention of rebleeding in large (≥1.5 cm) peptic ulcers.1 However, this study and some aspects of study design deserve further critical evaluation and interpretation.

    One hundred patients with peptic ulcer bleeding and lesion size ≥1.5 cm were randomised to OTSC or standard treatment. In the intention-to-treat analysis, the primary endpoint of clinical rebleeding within 30 days was achieved in 10% with OTSC vs 18% with standard therapy. The difference was statistically not significant.

    Two previously published RCTs assessing OTSC first-line therapy in non-variceal upper gastrointestinal (GI) bleeding have shown superiority to standard treatment.2 3 In both trials, only high-risk patients were included (eg, patients with haemodynamic instability or Rockall Score …

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    Footnotes

    • Contributors BM, AS and KC wrote the letter to the editor.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests BM received fees for research activities and lecture fees from Ovesco Endoscopy AG. AS received lecture fees and study grants from Ovesco Endoscopy AG. KC received lecture fees from Ovesco Endoscopy AG.

    • Provenance and peer review Not commissioned; internally peer reviewed.