P2468 - Role of Metoclopramide During Endoscopy in Patients With Upper Gastrointestinal Bleeding

Sahib Singh, MD¹, Ayushi Shah, MD², Bhanu Siva Mohan Pinnam, MD³, Babu Mohan, MD⁴, Vishnu Charan Suresh Kumar, MD⁵, Ganesh Aswath, MD⁵, Rakesh Vinayek, MD¹, Sudhir Dutta, MD¹, Dushyant S. Dahiya, MD⁶, Sumant Inamdar, MD⁷, Douglas Adler, MD⁸, Hassam Ali, MD⁹, Neil R Sharma, MD, FACG^10
1Sinai Hospital, Baltimore, MD; ²SUNY Upstate Medical University, Omaha, NE; ³John H. Stroger, Jr. Hospital of Cook County, Chicago, IL; ⁴Orlando Gastroenterology PA, Orlando, FL; ⁵SUNY Upstate Medical University, Syracuse, NY; ⁶The University of Kansas School of Medicine, Kansas City, KS; ⁷University of Arkansas for Medical Sciences, Little Rock, AR; ⁸Center for Advanced Therapeutic (CATE), Centura Health, Porter Adventist Hospital, Peak Gastroenterology, Denver, CO; ⁹ECU Health Medical Center, Greenville, NC; ¹⁰IOSE. Peak Gastroenterology & Gastrocare Partners., Colorado Springs, CO

Introduction: Metoclopramide, a prokinetic agent, has been shown to improve endoscopic mucosal visualization in patients with upper gastrointestinal bleeding (UGIB). However, the effect on clinical outcomes is unknown, with the studies reporting variable results. We performed a meta-analysis of the available data.

Methods: Online databases were searched for studies comparing metoclopramide to control (placebo or no medication) in UGIB patients undergoing esophagogastroduodenoscopy (EGD). The outcomes of interest were repeat EGD rate, patients requiring blood transfusions, mean blood units transfused, length of hospital stay (days), adverse events and mortality. Pooled odds ratios (OR) and standardized mean differences (SMD), along with 95% confidence intervals (CI) were calculated using a random effects model.

Results: A total of 6 studies (5 randomized controlled trials [RCTs] and 1 observational) with 22,944 patients (metoclopramide n=11,479, control n=11,465) were included. The mean age was 60 years and 59% of patients were men. No significant differences were observed between the metoclopramide and control groups with respect to repeat EGD rate (OR 1.04, 95% CI 0.95 to 1.13, p = 0.41) (Figure 1), patients needing blood transfusions (OR 0.90, 95% CI 0.68 to 1.18, p = 0.43), blood units transfused (SMD 0.03, 95% CI -0.14 to 0.21, p = 0.72), length of hospital stay (SMD -0.06, 95% CI -0.34 to 0.21, p = 0.64) and overall mortality (OR 0.97, 95% CI 0.76 to 1.24, p = 0.81). Metoclopramide use was not associated with any adverse events. The outcomes were consistent in subgroup analysis of only RCTs.

Discussion: As compared with the control group, using metoclopramide during endoscopy in patients with UGIB did not improve repeat EGD rate, need for blood transfusions or duration of hospitalization.



Disclosures:


Sahib Singh, MD¹, Ayushi Shah, MD², Bhanu Siva Mohan Pinnam, MD³, Babu Mohan, MD⁴, Vishnu Charan Suresh Kumar, MD⁵, Ganesh Aswath, MD⁵, Rakesh Vinayek, MD¹, Sudhir Dutta, MD¹, Dushyant S. Dahiya, MD⁶, Sumant Inamdar, MD⁷, Douglas Adler, MD⁸, Hassam Ali, MD⁹, Neil R Sharma, MD, FACG¹⁰. P2468 - Role of Metoclopramide During Endoscopy in Patients With Upper Gastrointestinal Bleeding, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.