Comparing Oral Vonoprazan and High Dose Intravenous PPI Infusion for Treating Bleeding Peptic Ulcers After Endoscopic Hemostasis

What this Trial Is About

Researchers are evaluating the use of oral Vonoprazan, a potassium-competitive acid blocker, compared to standard high dose proton pump inhibitor PPI therapy for patients with bleeding peptic ulcers who have received successful endoscopic haemostasis. This multicenter randomized controlled trial aims to determine whether Vonoprazan is not worse than the standard intravenous PPI infusion at preventing recurrent bleeding within 30 days. Upper gastrointestinal bleeding remains a serious condition, and effective acid suppression helps stabilize clots and prevent further bleeding. Participants will be randomly assigned to receive either a high dose PPI infusion consisting of an 80mg intravenous bolus of esomeprazole followed by continuous infusion at 8mg per hour for 72 hours, or oral Vonoprazan at 40mg twice daily for 72 hours followed by 20mg daily from day 4 to day 30. The study compares these two acid suppression methods after endoscopic treatment to assess their effects on recurrent bleeding and related outcomes. During the study, participants will be monitored for recurrent bleeding, need for additional hemostatic treatment, and length of hospital and intensive care stay within 30 days after randomization. Researchers will also investigate Vonoprazans effect on intragastric pH in this clinical setting. The total participation time includes treatment and follow-up assessments extending to 30 days after starting the assigned therapy.

PPI Infusion Versus Oral Acid Pump Inhibitors for Bleeding Peptic Ulcers