Sa1132 Proton-Pump Inhibitor (PPI) Versus Histamine-2 Receptor Antagonist (H2RA) for the Prevention of Recurrent Upper Gastrointestinal Bleeding (UGI) in High-Risk Users of Low-Dose Aspirin (ASA): An Interim Analysis

Abstract

BACKGROUND Previously we showed that PPI prevented recurrent UGI bleeding in ASA users with a history of UGI bleeding. Whether histamine-2 receptor antagonists (H2RAs) are an effective gastroprotective agent in these high-risk ASA users is unclear. We compared a PPI with an H2RA for prevention of recurrent ulcer bleeding with ASA. METHODS This was a 12-month, double-blind, randomized trial of rabeprazole versus famotidine in ASA users with a history of endoscopically confirmed nonvariceal UGI bleeding. After their ulcers had healed, we randomly assigned ASA users (80 mg once daily) with negative tests for Helicobacter pylori to receive either 20 mg of rabeprazole once daily or 40 mg of famotidine once daily for up to 12 months. Endoscopy was repeated if they developed symptoms of recurrent GI bleeding, had a drop in hemoglobin (Hb) >2 g/dL, withdrew early due to