Study of Patients With Drug-induced Non-variceal Upper Gastrointestinal Bleeding

NCT ID: NCT06945328

Last Updated: 2025-04-27

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Total Enrollment

100 participants

Study Classification

OBSERVATIONAL

Study Start Date

2025-05-31

Study Completion Date

2026-02-28

Brief Summary

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* To study the association between non-variceal UGIB and the use of NSAIDs, VKAs, DOACs and antiplatelet therapy.
* To compare the severity of bleeding related to specified drugs.
* To determine risk factors associated with non-variceal UGIB.

Detailed Description

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Upper gastrointestinal bleeding (UGIB) carries a high mortality, especially in elderly patients having co-morbidities, and the incidence of non-variceal and variceal bleeding is reported to be 3.5% and 15%, respectively.

Atrial fibrillation, deep vein thrombosis, pulmonary embolism, and other conditions require anticoagulation, non-steroidal anti-inflammatory drugs (NSAIDs) and antiplatelet therapy putting the patients at high risk of hemorrhage.

The latest American Heart Association (AHA) report on cardiovascular diseases suggests a doubling of the prevalence of atrial fibrillation by 2030 compared to 2010. The need to institute anticoagulation for this condition, both as primary and secondary prevention, will automatically increase the number of UGIB cases. An improvement in this regard has occurred with the advent of direct oral anticoagulants (DOACs) which have been shown to be non-inferior to vitamin K antagonists (VKAs).

In the event of UGIB, the Rockall score is a valid prediction score, repeatedly confirmed to assess the risk of patients with non-variceal bleeding. The management of UGIB is commonly adapted according to this score. Identifying high-risk patients who may benefit from longer hospitalization is crucial.

Conditions

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Upper Gastrointestinal Bleeding (UGIB)

Study Design

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Observational Model Type

OTHER

Study Time Perspective

CROSS_SECTIONAL

Interventions

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Upper endoscopy

All patients will do gastroscopy (upper endoscopy) within the first 24 hour of admission and specific elements of bleeding

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Adult patients (aged 18 years and above) presented with signs and symptoms of UGIB (hematemesis and/or melena)

Exclusion Criteria

* Variceal bleeding
* Age below 18 years
* Pregnant women
* Consent refusal
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Assiut University

OTHER

Sponsor Role lead

Responsible Party

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Nada Abdelfattah Ahmed

Principal investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Central Contacts

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Nada Abdelfattah Ahmed Abdelatty, Resident doctor

Role: CONTACT

+201006962358

Mohammed Ezz-Eldin Abd-Elmoneim, Lecturer

Role: CONTACT

+201018590854

References

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Kim BJ, Park MK, Kim SJ, Kim ER, Min BH, Son HJ, Rhee PL, Kim JJ, Rhee JC, Lee JH. Comparison of scoring systems for the prediction of outcomes in patients with nonvariceal upper gastrointestinal bleeding: a prospective study. Dig Dis Sci. 2009 Nov;54(11):2523-9. doi: 10.1007/s10620-008-0654-7. Epub 2008 Dec 23.

Reference Type BACKGROUND
PMID: 19104934 (View on PubMed)

Rockall TA, Logan RF, Devlin HB, Northfield TC. Influencing the practice and outcome in acute upper gastrointestinal haemorrhage. Steering Committee of the National Audit of Acute Upper Gastrointestinal Haemorrhage. Gut. 1997 Nov;41(5):606-11. doi: 10.1136/gut.41.5.606.

Reference Type BACKGROUND
PMID: 9414965 (View on PubMed)

Sjogren V, Bystrom B, Renlund H, Svensson PJ, Oldgren J, Norrving B, Sjalander A. Non-vitamin K oral anticoagulants are non-inferior for stroke prevention but cause fewer major bleedings than well-managed warfarin: A retrospective register study. PLoS One. 2017 Jul 10;12(7):e0181000. doi: 10.1371/journal.pone.0181000. eCollection 2017.

Reference Type BACKGROUND
PMID: 28700711 (View on PubMed)

Tsao CW, Aday AW, Almarzooq ZI, Alonso A, Beaton AZ, Bittencourt MS, Boehme AK, Buxton AE, Carson AP, Commodore-Mensah Y, Elkind MSV, Evenson KR, Eze-Nliam C, Ferguson JF, Generoso G, Ho JE, Kalani R, Khan SS, Kissela BM, Knutson KL, Levine DA, Lewis TT, Liu J, Loop MS, Ma J, Mussolino ME, Navaneethan SD, Perak AM, Poudel R, Rezk-Hanna M, Roth GA, Schroeder EB, Shah SH, Thacker EL, VanWagner LB, Virani SS, Voecks JH, Wang NY, Yaffe K, Martin SS. Heart Disease and Stroke Statistics-2022 Update: A Report From the American Heart Association. Circulation. 2022 Feb 22;145(8):e153-e639. doi: 10.1161/CIR.0000000000001052. Epub 2022 Jan 26.

Reference Type BACKGROUND
PMID: 35078371 (View on PubMed)

Piran S, Schulman S. Treatment of bleeding complications in patients on anticoagulant therapy. Blood. 2019 Jan 31;133(5):425-435. doi: 10.1182/blood-2018-06-820746. Epub 2018 Dec 17.

Reference Type BACKGROUND
PMID: 30559261 (View on PubMed)

Piccini JP, Hellkamp AS, Lokhnygina Y, Patel MR, Harrell FE, Singer DE, Becker RC, Breithardt G, Halperin JL, Hankey GJ, Berkowitz SD, Nessel CC, Mahaffey KW, Fox KA, Califf RM; ROCKET AF Investigators. Relationship between time in therapeutic range and comparative treatment effect of rivaroxaban and warfarin: results from the ROCKET AF trial. J Am Heart Assoc. 2014 Apr 22;3(2):e000521. doi: 10.1161/JAHA.113.000521.

Reference Type BACKGROUND
PMID: 24755148 (View on PubMed)

Ullrich H, Gori T. Antiplatelet therapies in patients with an indication for anticoagulation. Clin Hemorheol Microcirc. 2016;64(3):273-278. doi: 10.3233/CH-168104.

Reference Type BACKGROUND
PMID: 28128753 (View on PubMed)

Steffel J. Stroke Prevention with Non-Vitamin K Oral Anticoagulants: For Most, but Not for All! Cardiology. 2019;143(3-4):121-123. doi: 10.1159/000501586. Epub 2019 Jul 26. No abstract available.

Reference Type BACKGROUND
PMID: 31352454 (View on PubMed)

Hearnshaw SA, Logan RF, Lowe D, Travis SP, Murphy MF, Palmer KR. Acute upper gastrointestinal bleeding in the UK: patient characteristics, diagnoses and outcomes in the 2007 UK audit. Gut. 2011 Oct;60(10):1327-35. doi: 10.1136/gut.2010.228437. Epub 2011 Apr 13.

Reference Type BACKGROUND
PMID: 21490373 (View on PubMed)

Targownik LE, Nabalamba A. Trends in management and outcomes of acute nonvariceal upper gastrointestinal bleeding: 1993-2003. Clin Gastroenterol Hepatol. 2006 Dec;4(12):1459-1466. doi: 10.1016/j.cgh.2006.08.018. Epub 2006 Nov 13.

Reference Type BACKGROUND
PMID: 17101296 (View on PubMed)

Other Identifiers

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Gastrointestinal Bleeding

Identifier Type: -

Identifier Source: org_study_id

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