P0606 - Meta-Analysis of Hemostasis Outcomes With Hemospray in Managing Upper Gastrointestinal Bleeding

Rachel Porth, MD¹, Vikas Taneja, MD², Isha Taneja, ³, Kelsey Anderson, MD¹, Shaharyar Zuberi, MD¹, Duncan J. Flynn, MD¹, Joseph D. Feuerstein, MD^1
1Beth Israel Deaconess Medical Center, Boston, MA; ²Norwalk Hospital, Norwalk, CT; ³Massachusetts General Hospital for Children, Boston, MA

Introduction: Upper gastrointestinal bleeding (UGIB) is a common diagnosis that may require emergent management. While common endoscopic therapies including epinephrine injection, thermal, and mechanical therapies, can be effective, there are still significant rates of rebleeding. Hemospray (TC-325), a sprayable powder, has emerged as a relatively new treatment for endoscopic hemostasis that can cover large surface areas and is relatively easy to use. However, there is limited pooled data for Hemospray outcomes in immediate hemostasis and rates of rebleeding. We therefore conducted a meta-analysis evaluating the efficacy of Hemospray in adults with UGIB compared with traditional endoscopic techniques.

Methods: A systematic search was performed in PubMed for “hemospray” and “gastrointestinal hemorrhage”. Analysis was performed in R. Studies with UGIB adult patients using Hemospray compared to standard of care were included. Studies with 10 or fewer patients, case reports, letters to the editor, or review articles were excluded. The primary outcomes were immediate hemostasis, early rebleeding (within 7 days) and delayed rebleeding (30 day) after Hemospray application compared with standard of care endoscopic techniques to control bleeding.

Results: Four studies were included for analysis with 204 total patients. Participants were 62.7% male with an average age of 59.5 years. Primary cause of bleeding was variceal followed by malignancy and then peptic ulcer disease. Immediate hemostasis was more likely in the Hemospray group compared to standard of care (odds ratio [OR]=4.07, 95% confidence interval [CI] (1.53,10.80)). There was no difference in rates of early rebleeding (within 7 days) (OR=1.51, 95% CI (0.20,11.22) and delayed rebleeding (30 days) (OR=1.39, 95% CI (0.16,11.80) between the Hemospray and standard of care.

Discussion: Hemospray appears to be effective in the treatment for UGIB related to varices, malignancy and peptic ulcer disease. Further studies are needed to determine whether Hemospray should serve as a primary treatment for UGIB or only as a secondary therapy after initial failure of conventional measures.




Disclosures:


Rachel Porth, MD¹, Vikas Taneja, MD², Isha Taneja, ³, Kelsey Anderson, MD¹, Shaharyar Zuberi, MD¹, Duncan J. Flynn, MD¹, Joseph D. Feuerstein, MD¹. P0606 - Meta-Analysis of Hemostasis Outcomes With Hemospray in Managing Upper Gastrointestinal Bleeding, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.