Hemostatic powder bests standard endoscopic treatment for Hemostasis in malignant GI bleeding.

New research revealed that malignant gastrointestinal bleeding can be better controlled by using TC-325 hemostatic powder as it achieves greater immediate hemostasis and also has lower 30-day rebleeding rates when compared to contemporary standard endoscopic treatment. The study was published in the journal Gastroenterology. 

Gastrointestinal (GI) bleeding is the major global cause of morbidity and mortality. In recent years its incidence has steadily increased. As there is an immense necessity to control bleeding, hemostatic agents have been introduced that control bleeding effectively. But there is no sufficient data on the role of hemostatic powders when managing patients with malignant gastrointestinal (GI) bleeding due to varying guidelines and low-quality evidence. Hence researchers conducted a patient- and outcome-assessor-blinded multicenter randomized controlled trial to assess the role of hemostatic powders on GI bleeding. 

TC-325 alone or standard endoscopic therapy (SET) was randomly assigned to patients who presented with active bleeding from an upper or lower GI lesion believed to be malignant at index endoscopy between June 2019 and January 2022. 30-day rebleeding was the main goal, with rapid hemostasis and other clinically significant outcomes serving as supplementary targets.

Key findings: 

• About 106 patients comprised the study population with 55 TC-325 and 51 SET.
• There was no difference between the baseline characteristics and endoscopic findings between the groups.
• TC-325 group showed significantly lower Thirty-day rebleeding rates.
• Immediate hemostasis rates were 100% in the TC-325 versus 68.6% in the SET group.
• There was no difference in the other secondary outcomes between the two groups.
• Independent predictors of 6-month survival included the Charlson comorbidity index and receiving an additional Non-endoscopic hemostatic or oncological treatment 30 days after the index endoscopy after adjustment for functional status, Glasgow-Blatchford score, and an upper GI source of bleeding. 

Thus, when compared to modern SET, TC-325 hemostatic powder produces higher rates of immediate hemostasis and lower rates of 30-day rebleeding. 

Further reading: Hemostatic powder vs. standard endoscopic treatment for gastrointestinal tumor bleeding: A multicenter randomized trial. https://doi.org/10.1053/j.gastro.2023.05.042