Low-dose rabeprazole (5 mg) prevented significant GI bleeding and peptic ulcers in high bleeding risk patients on chronic antithrombotic therapy over 1 year.
Does low-dose rabeprazole prevent significant gastrointestinal events in high bleeding risk patients receiving chronic antithrombotic therapy?
Low-dose rabeprazole (5 mg) is highly effective and safe for preventing gastrointestinal bleeding in high bleeding risk patients on chronic antithrombotic therapy.
Absolute Event Rate: 0% vs 0%
Abstract Background The widespread use of antithrombotic therapies increases bleeding risk, particularly in patients with a high bleeding risk (HBR). Although proton pump inhibitors are recommended for lowering the risk of upper gastrointestinal (UGI) bleeding, the optimal agent and dosage remain uncertain. Purpose This study evaluated the efficacy and safety of low-dose rabeprazole (LORA, 5 mg) for preventing GI-related adverse events in HBR patients receiving chronic antithrombotic therapy. Methods This was a prospective, multicenter, interventional study that included 909 South Korean patients (mean age 72.9 ± 8.3 years; male 71.3% n=648) receiving long-term antithrombotic therapy with HBR features including age ≥70 years, dual antiplatelet therapy, combined antithrombotic regimens, and prior GI bleeding. The primary endpoint was the incidence of significant GI events, including overt/occult bleeding and symptomatic peptic ulcer disease (PUD). Secondary endpoints included study drug discontinuation owing to GI adverse events, composite cardiovascular events, and all-cause mortality. Results The median follow-up period was 364 days (IQR, 350–385 days). Most patients presented with one (74.4%, n=676) or two (24.6%, n=224) HBR characteristics. No patients had significant UGI bleeding or symptomatic PUD during low-dose rabeprazole administration. The median adherence rate was 92.0% (interquartile range IQR, 87.0–95.0). Drug discontinuation owing to GI symptoms occurred in 32 patients (3.52%) at a median of 81 days (IQR, 36–119 days). GI-related adverse events were reported in 3.96%, with diarrhea, epigastric discomfort, and constipation being the most common. Non-GI bleeding and cardiovascular composite events occurred in 0.33% (n=3) each, with all-cause mortality at 0.55% (n=5). Conclusions Low-dose rabeprazole effectively prevented GI complications in patients receiving chronic antithrombotic therapy, demonstrating a favorable safety profile and high adherence. Further studies with larger and broader populations are required to confirm these findings.Low-dose rabeprazole in HBR CVD patients
Park et al. (Sat,) reported a other. Low-dose rabeprazole (5 mg) prevented significant GI bleeding and peptic ulcers in high bleeding risk patients on chronic antithrombotic therapy over 1 year.