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TC-325 Superiority in Malignant Gastrointestinal Bleeding: An Individual Patient Data Meta-Analysis of Randomized
Ali A Alali1,2, Rapat Pittayanon3, Myriam Martel4
1Department of Medicine, Faculty of Medicine, Kuwait University, Jabriya, Kuwait.
The American Journal of Gastroenterology
|September 9, 2024
Summary
Topical TC-325 (Hemospray) shows promise for malignant gastrointestinal bleeding (GIB). This agent achieved better immediate hemostasis and reduced rebleeding compared to conventional methods in a meta-analysis.
Area of Science:
- Gastroenterology
- Endoscopy
- Oncology
Background:
- Topical hemostatic agents are recommended for peptic ulcer bleeding.
- Their efficacy in malignant gastrointestinal bleeding (GIB) is not well-established.
Purpose of the Study:
- To assess the efficacy of topical hemostatic agents in managing malignant GIB.
- To compare TC-325 (Hemospray) with conventional endoscopic modalities.
Main Methods:
- Individual patient data meta-analysis of randomized controlled trials (RCTs) up to November 2023.
- Included 3 RCTs (160 patients) evaluating TC-325 for malignant GIB.
- Assessed immediate hemostasis, 30-day rebleeding, further bleeding, mortality, and adverse events.
Main Results:
- TC-325 significantly improved immediate hemostasis compared to conventional methods (OR 46.6).
- TC-325 demonstrated significantly lower 30-day rebleeding (OR 0.28) and further bleeding (OR 0.11).
- No significant differences in mortality or need for additional treatment; no adverse events reported.
Conclusions:
- TC-325 appears superior to conventional endoscopic therapy for malignant GIB.
- Evidence suggests TC-325 improves hemostasis and reduces rebleeding, despite low-to-very-low certainty.
- TC-325 showed particular benefit in upper GIB subgroup analysis.
