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Hemospray, a hemostatic topical mineral powder, is an effective initial treatment for patients with actively bleeding peptic ulcers.
A prospective, multicenter, single-arm study (Hemostasis of Active GI Luminal Tract Bleeding [HALT]) revealed safety and efficacy of Hemospray monotherapy in attaining immediate hemostasis in people with active peptic ulcer bleeding. Researchers sought to explore efficacy and safety of hemostatic powder as a monotherapy to manage peptic ulcer bleeding in people with endoscopically confirmed Forrest Ia or Ib peptic ulcers.
Participants underwent endoscopic application of Hemospray as therapy of first intent. The effectiveness outcomes included successful hemostasis at the end of the index endoscopy, recurrent bleeding within 72 hours and from 72 hours to 30 days, side effects requiring reintervention or resulting in mortality or morbidity, and 30-day mortality.
Hemospray was successfully given in 98.5% of people (66/67). Hemostasis was attained at the index endoscopy in 90.9% of people (60/66) with Hemospray alone, and in an additional four people treated with additional modalities, offering an overall hemostasis rate of 97% (64/66). Rebleeding was noted to occur in 13.3% (8/60), 5 within 72 hours, and 3 others between 72 hours and 30 days.
Notably, 2 cases of perforation and 2 patient deaths were noted during the study. However, none of these cases or any other adverse events were attributed to Hemospray usage. The rate of early rebleeding was considerably greater in people with Forrest Ia ulcers when compared to people with Forrest Ib ulcers.
Greater rates of early bleeding in people with Forrest Ia ulcers showed consistency with the findings from studies where Hemospray was used as a rescue following the failure of conventional methodology. Thus, the use of Hemospray is valuable for active peptic ulcer bleeding management. However, it is pivotal to monitor for recurrent bleeding.
Gastrointestinal Endoscopy
The use of topical mineral powder as monotherapy for treatment of active peptic ulcer bleeding
Joseph J.Y.Sung et al.
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