Comparison of TC-325 Hemostatic Powder with Standard Endoscopic Treatments for Malignancy-Related Upper Gastrointestinal Bleeding: Meta-Analysis of Randomized Controlled Trials.

Umar Hayat, Zahid Ijaz Tarar, Umer Farooq, Faisal Kamal, Muhammad Ali Khan, Sachit Sharma, Muhammad Aziz, Aamir Saeed, Saira Yousuf, Muhammad Hashim Hayat, Marjan Haider, Christian Salcedo

Journal: Digestive diseases and sciences 2024;69(11):4224-4230

PMID: 39354271

Abstract

BACKGROUND

TC-325 powder has been successfully used in the management of malignancy-related upper gastrointestinal bleeding (UGIB) with favorable results. We conducted a meta-analysis of randomized controlled trials (RCTs) comparing TC-325 hemostatic powder with standard endoscopic treatments in the management of malignancy-related UGIB.

METHODS

Several databases were reviewed from inception to May 02, 2024 to identify RCTs comparing TC-325 and standard endoscopic treatments for the management of malignancy-related UGIB. Our outcomes of interest were immediate hemostasis, 30-day rebleeding, length of hospital stay, need for surgery, need for angiographic embolization, and all-cause mortality. We calculated pooled risk ratio (RR) with 95% confidence intervals (CI) for categorical variables and mean difference (MD) with 95% CI for continuous variables. We used a random effect model to analyze the data and heterogeneity was assessed by I statistic.

RESULTS

Four RCTs with 227 patients were included. We found that, the rate of immediate hemostasis was significantly higher in the TC-325 group compared to the standard therapy group, RR (95% CI): 1.48 (1.26, 1.74). There was no significant difference in 30-day rebleeding between the groups RR (95% CI): 0.52 (0.15, 1.76). We found no significant difference in other outcomes between groups such as the need for angiographic embolization, all-cause mortality, length of hospital stay, and need for surgery.

CONCLUSIONS

We found that, TC-325 hemostatic powder was superior to standard endoscopic treatments in achieving immediate hemostasis in patients with malignancy-related UGIB.

© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Address: Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.; Department of Gastroenterology, Trinity Health Ann Arbor, Ypsilanti, MI, USA.; Division of Gastroenterology, Bon Secours Mercy Health, Toledo, OH, USA.; Division of Gastroenterology, Geisinger Wyoming Valley Medical Centre, Wilkes-Barre, PA, USA.; Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA.; Department of Gastroenterology, University of Missouri-Columbia, Columbia, MO, USA.; Division of Gastroenterology, St Louis University School of Medicine, St Loius, MO, USA.; Division of Gastroenterology, Virginia Commonwealth University, Richmond, VA, USA.; Department of Gastroenterology, Hepatology and Nutrition, University of Texas MD Anderson Cancer Center, Houston, TX, USA.; Division of Gastroenterology, Thomas Jefferson University Hospital, 132 South 10th Street, Main Building, Suite 480, Philadelphia, PA, 19107, USA. [email protected].

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