{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T05:38:57Z","timestamp":1791005937940,"version":"4.1.0"},"reference-count":29,"publisher":"Georg Thieme Verlag KG","issue":"09","funder":[{"name":"ESGE Research Grant","award":["2019 ESGE Research Grant"],"award-info":[{"award-number":["2019 ESGE Research Grant"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n            Background First-line over-the-scope (OTS) clip treatment has shown higher efficacy than standard endoscopic therapy in acute nonvariceal upper gastrointestinal bleeding (NVUGIB) from different causes. We compared OTS clips with through-the-scope (TTS) clips as first-line mechanical treatment in the specific setting of peptic ulcer bleeding.<\/jats:p><jats:p>\n            Methods We conducted an international, multicenter randomized controlled trial on consecutive patients with suspected NVUGIB. Patients with Forrest Ia\u2013IIb gastroduodenal peptic ulcer were randomized 1:1 to OTS clip or TTS clip treatment. The primary outcome was the rate of 30-day rebleeding after successful initial hemostasis. Secondary outcomes included the rates of successful initial hemostasis and overall clinical success, defined as the composite of successful initial hemostasis and no evidence of 30-day rebleeding.<\/jats:p><jats:p>\n            Results 251 patients were screened and 112 patients were randomized to OTS (n = 61) or TTS (n = 51) clip treatment. The 30-day rebleeding rates were 1.6% (1\/61) and 3.9% (2\/51) in patients treated with OTS clips and TTS clips, respectively (Kaplan\u2013Meier log-rank, P = 0.46). Successful initial hemostasis rates were 98.4% (60\/61) in the OTS clip group and 78.4% (40\/51) in the TTS clip group (P = 0.001). Overall clinical success rates were 96.7% (59\/61) with OTS clips and 74.5% (38\/51) with TTS clips (P = 0.001).<\/jats:p><jats:p>\n            Conclusions Low rates of 30-day rebleeding were observed after first-line endoscopic treatment of acute peptic ulcer bleeding with either OTS or TTS clips. However, OTS clips showed higher efficacy than TTS clips in achieving successful initial hemostasis and overall clinical success.<\/jats:p>","DOI":"10.1055\/a-2303-4824","type":"journal-article","created":{"date-parts":[[2024,4,11]],"date-time":"2024-04-11T00:13:40Z","timestamp":1712794420000},"page":"665-673","source":"Crossref","is-referenced-by-count":25,"title":["Over-the-scope clip as first-line treatment of peptic ulcer bleeding: a multicenter randomized controlled trial (TOP Study)"],"prefix":"10.1055","volume":"56","clinical-trial-number":[{"clinical-trial-number":"nct03551262","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Paola","family":"Soriani","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, Azienda USL Modena, Carpi, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Biancheri","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, Azienda USL Modena, Carpi, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuliano Francesco","family":"Bonura","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, Azienda USL Modena, Carpi, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tommaso","family":"Gabbani","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, Azienda USL Modena, Carpi, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2852-6042","authenticated-orcid":false,"given":"Enrique","family":"Rodriguez de Santiago","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Hospital Universitario Ram\u00f3n y Cajal, Madrid, Spain"},{"name":"Instituto Ram\u00f3n y Cajal de Investigaci\u00f3n Sanitaria (IRYCIS), Madrid, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red en el \u00c1rea tem\u00e1tica de Enfermedades Hep\u00e1ticas y Digestivas (CIBEREHD), Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4975-018X","authenticated-orcid":false,"given":"Lorenzo","family":"Dioscoridi","sequence":"additional","affiliation":[{"name":"Digestive and Interventional Endoscopy Unit, Niguarda Hospital, ASST Niguarda, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca","family":"Andrisani","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Unit, Campus Bio-Medico, University of Rome, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmelo","family":"Luigiano","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Unit, ASST Santi Paolo e Carlo, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Deiana","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, Azienda USL Modena, Carpi, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim","family":"Rainer","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, Azienda USL Modena, Carpi, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariagrazia","family":"Del Buono","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, Azienda USL Modena, Carpi, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rocco","family":"Amendolara","sequence":"additional","affiliation":[{"name":"Research Office, Azienda USL Modena, Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimiliano","family":"Marino","sequence":"additional","affiliation":[{"name":"Clinical Governance Unit, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cesare","family":"Hassan","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy"},{"name":"Endoscopy Unit, Humanitas Clinical and Research Center - IRCCS, Rozzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Repici","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy"},{"name":"Endoscopy Unit, Humanitas Clinical and Research Center - IRCCS, Rozzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Manno","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, Azienda USL Modena, Carpi, 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