Continuation of low-dose aspirin therapy in peptic ulcer bleeding: a randomized trial

Area of Science:

• Gastroenterology
• Cardiology
• Clinical Trials

Background:

• Uncertainty exists regarding the continuation of aspirin therapy post-endoscopic hemostasis for peptic ulcer bleeding.
• Patients on low-dose aspirin with peptic ulcer bleeding require clear management guidelines.

Purpose of the Study:

• To evaluate if continuing aspirin therapy with proton-pump inhibitors is non-inferior to stopping aspirin in preventing recurrent ulcer bleeding.
• To assess the impact of continuous aspirin therapy on mortality rates in patients with cardiovascular or cerebrovascular diseases.

Main Methods:

• A parallel, randomized, placebo-controlled, double-blind noninferiority trial.
• Involved 156 patients with peptic ulcer bleeding receiving low-dose aspirin.
• Compared 8-week aspirin (80 mg/d) plus proton-pump inhibitors versus placebo plus proton-pump inhibitors.

Main Results:

• Recurrent ulcer bleeding within 30 days occurred in 10.3% of the aspirin group versus 5.4% in the placebo group.
• All-cause mortality was significantly lower in the aspirin group (1.3% vs. 12.9%).
• Mortality from cardiovascular, cerebrovascular, or gastrointestinal complications was also reduced in the aspirin group (1.3% vs. 10.3%).

Conclusions:

• Continuous low-dose aspirin therapy post-peptic ulcer bleeding may increase recurrent bleeding risk.
• Continuous aspirin therapy potentially reduces mortality rates in this patient population.
• Larger trials are needed to validate these findings and refine clinical recommendations.