Continuation of low-dose aspirin combined with rabeprazole on healing of peptic ulcer bleeding

Abstract

Objective To investigate the effect of low-dose aspirin combined with rabeprazole on the healing of peptic ulcer after hemostasis with aspirin-related peptic ulcer bleeding, and to explore the independent factors associated with ulcer healing failure. Methods A total of 138 patients with acute upper gastrointestinal hemorrhage in the Department of Gastroenterology of the Second Affiliated Hospital of Fujian Medical University from June 2016 to June 2018 were enrolled.The clinical data of 138 patients with upper gastrointestinal ulcer bleeding caused by aspirin were analyzed.The patients were randomly divided into two groups.Aspirin group (n=68) received aspirin 100 mg/d plus rabeprazole 80 mg/d, while the placebo group (n=70) received rabeprazole 80 mg/d plus placebo.The patients were treated for 8 weeks.Subjects with H. pylori infection were treated with standard quadruple therapy.Follow-up endoscopy was performed at the end of 8 weeks.The primary endpoint was the healing of peptic ulcers. Results The ulcer healing rate was 79.4%(54/68) in the aspirin group and 84.3%(59/70) in the placebo group.There was no statistically significant difference between the two groups(χ2=0.552, P>0.05). There were 5 cases of ulcer bleeding in aspirin group and placebo group.The rehaemorrhage rate was 7.4%(5/68) and 7.1%(5/70), respectively.There was no statistically significant difference between the two groups(χ2=0.002, P>0.05). Among the factors affecting the healing of aspirin-associated peptic ulcer, the healing rate was significantly associated with steroid use during treatment (χ2=6.135, P=0.041) and smoking status(χ2=5.616, P=0.018). Other factors, including age, hypertension, diabetes, alcohol history, history of previous ulcer bleeding, initial Helicobacter pylori status, and ulcer location did not affect ulcer healing. Conclusion After aspirin-associated peptic ulcer bleeding, continued low-dose aspirin plus rabeprazole did not affect the healing of peptic ulcers, and the use of steroids and smoking status are independent risk factors for ulcer healing. Key words: Dose-response relationship, drug; Aspirin; Nonsteroidal antiinflammatory drugs; Rabeprazole; Drug therapy, combination; Peptic ulcer hemorrhage; Peptic ulcer; Risk factors