Skip to main content

Advertisement

SpringerLink
Log in

CEGP-003 Spray Has a Similar Hemostatic Effect to Epinephrine Injection in Cases of Acute Upper Gastrointestinal Bleeding

  • Original Article
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Background

Endoscopically applicable hemostatic agents have been demonstrated to have high initial hemostasis rates in cases of upper gastrointestinal bleeding (UGIB).

Aims

The authors developed a new hemostatic powder (CEGP-003) and evaluated its hemostatic and ulcer healing effects in UGIB.

Methods

Patients with peptic ulcer or post-endoscopic resection bleeding were randomly assigned to be treated by epinephrine injection or CEGP-003 spray. All patients were placed under observation for 3 days and underwent second-look endoscopy. The primary outcome was initial hemostasis rate, and the secondary outcomes were rebleeding rate and ulcer healing effect.

Results

Seventy-two patients with UGIB were enrolled in this study. Causes of bleeding were peptic ulcer (15, 20.5%), post-endoscopic mucosal resection (11, 15.1%), and post-endoscopic submucosal dissection bleeding (47, 64.4%). Initial hemostasis was achieved in 89.2% (34/37) of patients in the epinephrine group and in 100% (35/35) in the CEGP-003 group (p = 0.115). Rebleeding occurred in 2.7% (1/37) and 8.6% (3/35) in the epinephrine and CEGP-003 groups, respectively (p = 0.35). Three days after endoscopic hemostasis, the ulcer healing effects of epinephrine and CEGP-003 were similar (p = 0.79).

Conclusion

This study shows that CEGP-003 spray has a hemostatic effect similar to epinephrine in terms of initial hemostasis and rebleeding rates. The authors consider CEGP-003 a potential therapeutic tool for UGIB as a definitive or bridge therapy and that it is particularly useful for oozing lesions after endoscopic resection.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Gralnek IM, Barkun AN, Bardou M. Management of acute bleeding from a peptic ulcer. New Engl J Med. 2008;359:928–937.

    Article  CAS  Google Scholar 

  2. Asge Technology Committee, Conway JD, Adler DG, et al. Endoscopic hemostatic devices. Gastrointest Endosc. 2009;69:987–996.

    Article  Google Scholar 

  3. Bustamante-Balen M, Plume G. Role of hemostatic powders in the endoscopic management of gastrointestinal bleeding. World J Gastrointest Pathophysiol. 2014;5:284–292.

    Article  Google Scholar 

  4. Sung JJ, Luo D, Wu JC, et al. Early clinical experience of the safety and effectiveness of Hemospray in achieving hemostasis in patients with acute peptic ulcer bleeding. Endoscopy. 2011;43:291–295.

    Article  CAS  Google Scholar 

  5. Goker H, Haznedaroglu IC, Ercetin S, et al. Haemostatic actions of the folkloric medicinal plant extract Ankaferd blood stopper. J Int Med Res. 2008;36:163–170.

    Article  CAS  Google Scholar 

  6. Karaman A, Baskol M, Gursoy S, et al. Endoscopic topical application of Ankaferd blood stopper(R) in gastrointestinal bleeding. J Altern Complement Med. 2012;18:65–68.

    Article  Google Scholar 

  7. Changela K, Papafragkakis H, Ofori E, et al. Hemostatic powder spray: A new method for managing gastrointestinal bleeding. Therap Adv Gastroenterol. 2015;8:125–135.

    Article  CAS  Google Scholar 

  8. Haddara S, Jacques J, Lecleire S, et al. A novel hemostatic powder for upper gastrointestinal bleeding: A multicenter study (the “GRAPHE” registry). Endoscopy. 2016;48:1084–1095.

    Article  Google Scholar 

  9. Sakita T, Fukutomi H. Endoscopic diagnosis. In: Yoshitoshi Y, ed. Ulcer of Stomach and Duodenum. 1st ed. Tokyo: Nankodo; 1971:198–208.

    Google Scholar 

  10. Lee JW, Park JH, Robinson JR. Bioadhesive-based dosage forms: The next generation. J Pharm Sci. 2000;89:850–866.

    Article  CAS  Google Scholar 

  11. Kaehler G, Dutenhoefner C, Magdeburg R. Endoscopic application of polysaccharide powder for hemostasis in anticoagulated pigs (with video). Gastrointest Endosc. 2015;82:161–163.

    Article  Google Scholar 

  12. Jacques J, Legros R, Chaussade S, Sautereau D. Endoscopic haemostasis: An overview of procedures and clinical scenarios. Dig Liver Dis. 2014;46:766–776.

    Article  Google Scholar 

  13. Frenkel JS. The role of hyaluronan in wound healing. Int Wound J. 2014;11:159–163.

    Article  Google Scholar 

  14. Hara-Chikuma M, Verkman AS. Roles of aquaporin-3 in the epidermis. J Investig Dermatol. 2008;128:2145–2151.

    Article  CAS  Google Scholar 

  15. Maeng JH, Bang BW, Lee E, et al. Endoscopic application of EGF-chitosan hydrogel for precipitated healing of GI peptic ulcers and mucosectomy-induced ulcers. J Mater Sci Mater Med. 2014;25:573–582.

    Article  CAS  Google Scholar 

  16. Bang BW, Maeng JH, Kim MK, Lee DH, Yang SG. Hemostatic action of EGF-endospray on mucosectomy-induced ulcer bleeding animal models. Biomed Mater Eng. 2015;25:101–109.

    PubMed  Google Scholar 

  17. Barkun AN, Bardou M, Kuipers EJ, et al. International consensus recommendations on the management of patients with nonvariceal upper gastrointestinal bleeding. Ann Intern Med. 2010;152:101–113.

    Article  Google Scholar 

  18. Laine L, McQuaid KR. Endoscopic therapy for bleeding ulcers: An evidence-based approach based on meta-analyses of randomized controlled trials. Clin Gastroenterol Hepatol. 2009;7:33–47.

    Article  Google Scholar 

  19. Oka S, Tanaka S, Kaneko I, et al. Advantage of endoscopic submucosal dissection compared with EMR for early gastric cancer. Gastrointest Endosc. 2006;64:877–883.

    Article  Google Scholar 

  20. Park SJ, Park H, Lee YC, et al. Effect of scheduled second-look endoscopy on peptic ulcer bleeding: A prospective randomized multicenter trial. Gastrointest Endosc. 2018;87:457–465.

    Article  Google Scholar 

Download references

Funding

This work was supported by Inha University Research Grant (2017).

Author information

Authors and Affiliations

  1. Division of Gastroenterology, Department of Internal Medicine, Inha University Hospital, Inha University College of Medicine, 27, Inhang-ro, Jung-gu, Incheon, 22332, South Korea

    Byoung Wook Bang, Don Haeng Lee, Hyung Kil Kim, Kye Sook Kwon & Yong Woon Shin

  2. Department of Internal Medicine, Digestive Disease Center and Research Institute, Soon Chun Hyang University College of Medicine, Bucheon, South Korea

    Su Jin Hong & Jong Ho Moon

Authors
  1. Byoung Wook Bang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Don Haeng Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hyung Kil Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kye Sook Kwon
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yong Woon Shin
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Su Jin Hong
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jong Ho Moon
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

BWB made substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data and was involved in drafting the manuscript or revising it critically for important intellectual content. HKK, KSK, YWS, SJH, and JHM made substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data. DHL has been involved in drafting the manuscript or revising it critically for important intellectual content.

Corresponding author

Correspondence to Don Haeng Lee.

Ethics declarations

Conflict of interest

The authors declare that they have no competing interests.

Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bang, B.W., Lee, D.H., Kim, H.K. et al. CEGP-003 Spray Has a Similar Hemostatic Effect to Epinephrine Injection in Cases of Acute Upper Gastrointestinal Bleeding. Dig Dis Sci 63, 3026–3032 (2018). https://doi.org/10.1007/s10620-018-5208-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-018-5208-z

Keywords

Search

Navigation