Higher efficacy of over-the-scope clips compared to through-the-scope clips for first-line endoscopic treatment of acute peptic ulcer bleeding: results of an international, multi-center, randomized controlled trial

Aims First-line over-the-scope clip (OTS-clip) treatment has shown higher efficacy than standard endoscopic therapy in acute non-variceal upper GI bleeding from several different causes [1] [2]. However, no randomized controlled trial (RCT) comparing first-line mechanical treatment with OTS-clip vs through-the-scope clips (TTSCs) in the specific setting of peptic ulcer (PU) bleeding has been performed to date. This was our study aim (▶Table [1]).