Pantoprazole in COMPASS — No Prevention of Gastroduodenal Events or Other Useful Net Results

The authors ’ conclusions are that “routine use of proton pump inhibitors [PPIs] in patients receiving low-dose anticoagulation and/or aspirin for stable cardiovascular disease does not reduce upper gastrointestinal events, but may reduce bleeding from gastroduodenal lesions.”1 We deem the latter statemen t questionable and a forcing of the data.Indeed, the primary outcome was an “upper GI event,” which includes a composite of overt bleeding (hematemesis and/or melena) with a gastroduodenal lesion (peptic ulcer or neoplasia confirmed by endoscopy or radiology) that is bleeding at the time of the procedure, overt upper GI bleeding of unknown origin (patient presents with hematemesis with or without melena that was thought by the attending clinician to relate to the upper GI tract), occult bleeding (drop in the hemoglobin of ≥2 g/dL), symptomatic gastroduodenal ulcer with at least 3 days of GI pain, or at least 5 gastroduodenal erosions (confirmed by endoscopy) with at least 3 days of GI pain, upper GI obstruction, or perforation.

Source: Gastroenterology - November 4, 2019 Category: Gastroenterology Authors: Alberto Donzelli, Giulia Giudicatti Tags: Correspondence Source Type: research