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Efficacy of Hemospray in non-variceal upper gastrointestinal bleeding: a systematic review with meta-analysis

Department of Internal Medicine, University of Toledo Medical Center, Toledo, Ohio (Muhammad Aziz, Zubair Khan, Rawish Fatima). Department of Medicine, Hackensack University-Palisades Medical Center, North Bergen, New Jersey (Simcha Weissman). Department of Medicine, University of South Dakota Sanford school of Medicine, Sioux Falls, South Dakota (Tej I. Mehta). Department of Gastroenterology, University of Toledo Medical Center, Toledo, Ohio (Shafae Hassan, Ali Nawras). Department of Gastroenterology, Maimonides Medical Center, Brooklyn, New York (Yuriy Tsirlin). Division of Gastroenterology and Hepatology, Hackensack University-Palisades Medical Center, North Bergen, New Jersey (Ammar Hassan, Michael Sciarra). Department of Gastroenterology and Hepatology, University of Kansas Medical Center, Kansas City, Kansas (Amit Rastogi), USA.

Annals of gastroenterology. 2020;33(2):145-154
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Abstract
Background: Recently, amongst other hemostatic modalities, Hemospray (TC-325) has emerged as an effective method for managing patients with non-variceal upper gastrointestinal bleeding (GIB). We conducted this systematic review and meta-analysis to assess the efficacy of Hemospray in patients with non-variceal upper GIB. Methods: Our primary outcomes were clinical and technical success; secondary outcomes were aggregate rebleeding, early rebleeding, delayed rebleeding, refractory bleeding, mortality, and treatment failure. A meta-analysis of proportions was conducted for all reported primary and secondary outcomes. A relative risk meta-analysis was conducted for studies reporting direct comparisons between Hemospray and other hemostatic measures. Results: A total of 20 studies with 1280 patients were included in the final analysis. Technical success of Hemospray was seen in 97% of cases (95% confidence interval [CI] 94-98%, I (2)=52.89%) and a significant trend towards increasing technical success was seen during publication years 2011-2019. Clinical success of Hemospray was seen in 91% of cases (95%CI 88-94%, I (2)=47.72%), compared to 87% (95%CI 75-94%, I (2)=0.00%) for other hemostatic measures. The secondary outcomes of aggregate rebleeding, early rebleeding, delayed rebleeding, refractory rebleeding, mortality and treatment failure following the use of Hemospray were seen in 27%, 20%, 9%, 8%, 8%, and 31% of cases, respectively. Conclusion: Hemospray is safe, effective and non-inferior to traditional hemostatic measures for the management of non-variceal upper GIB, and can thus be used as an alternative option.
Study details
Study Design : Systematic Review
Language : eng
Credits : Bibliographic data from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine