About this trial
Upper gastrointestinal bleeding (UGIB) is a common and potentially lethal medical emergency, which requires hospitalization and healthcare resources. Despite the changing epidemiology and advancement of endoscopic therapy in the recent decade, the all-cause mortality of UGIB remains high (\>2%). An accurate risk stratification is necessary to triage patients into low- or high-risk groups, in order to inform clinicians for the necessity and timing of urgent endoscopy. However, existing pre-endoscopy risk scores, such as the Glasgow-Blatchford score (GBS), Rockall score and AIMS65 score, are suboptimal in predicting relevant clinical outcomes. An alternative strategy for risk stratification is urgently warranted in patients with UGIB to guide the next step of management.
In a pre-clinical study, the sensitivity and specificity of HemoPill® prototype were 95% and 87.5% respectively, when the sensors were positioned close to the bleeding point. Furthermore, several human clinical studies have proven the feasibility and accuracy of HemoPill® in healthy volunteers and patients with suspected UGIB. Capsule ingestion was well tolerated with no device-related adverse event or capsule retention. All patients with negative HI were found to have no active endoscopic bleeding (true negative, 100%, 17/17). In patients with bleeding \>20ml, true positive HI signals were detected (100%, 2/2) In a retrospective multi-center study, 61 patients with suspected UGIB were recruited to use HemoPill®. Among the capsule-positive cases, subsequent endoscopy confirmed active bleeding in 57% (20/35) of them. None of the capsule-negative patients rebled (0%, 0/25), which prevented unnecessary emergent endoscopy in 72% of them (18/25).
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Participants have symptoms and signs of suspected UGIB (melena, per rectal bleeding, coffee ground vomiting, prior hematemesis);
Participants will undergo urgent or elective OGD within 24 hours from recruitment;
Written consent obtained.
Disqualifiers
Contraindications for OGD (e.g. respiratory failure, suspected perforation);
Contraindications for capsule endoscopy (e.g. known gastrointestinal obstruction or stricture, severe dysphagia, impaired consciousness);
Cardiac pacemaker or implanted electromedical devices;
History of gastrectomy or bowel resection;
Trial design
Single group
Treatments tested in this trial
Hemopill
DeviceHemopill will be swallowed to detect the presence of active bleeding in the upper GI tract
OGD
Procedure/SurgeryOGD will be performed to compare the results of the hemopill
Treatment groups
Trial outcomes
Primary outcomes
Presence of active bleeding
Presence of active bleeding, old blood or potential bleeding sources during OGD examination, which warrants endoscopic haemostatic treatment.
Secondary outcomes
Technical success rate
Technical success rate
Adverse event rate
Adverse event rate
Capsule retention rate
Capsule retention rate
Time from Hemopill acute capsule ingestion to a positive HI signal
Time from Hemopill acute capsule ingestion to a positive HI signal
Sponsors and contacts
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