High-dose vs. Low-dose Proton Pump Inhibitors post-endoscopic hemostasis in patients with bleeding peptic ulcer. A meta-analysis and meta-regression analysis
| Autor: | Itseoritse Kpogho, Androniki Poulou, George Chatzidakis, Panagiota Malliou, Aphroditi Vagia, George Sgourakis, George Ravanis, Stankovicová T, Theodoros Argyropoulos, Hana Tsuruhara, Adam Briki |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Lansoprazole Cochrane Library Postoperative Hemorrhage 2-Pyridinylmethylsulfinylbenzimidazoles law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Internal medicine Medicine Humans Pantoprazole Aged Randomized Controlled Trials as Topic Dose-Response Relationship Drug business.industry Hemostasis Endoscopic Gastroenterology Proton Pump Inhibitors Odds ratio Middle Aged Confidence interval Peptic Ulcer Hemorrhage Treatment Outcome 030220 oncology & carcinogenesis Hemostasis Meta-analysis Regression Analysis 030211 gastroenterology & hepatology Female Original Article business medicine.drug |
| Zdroj: | The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology. 29(1) |
| ISSN: | 2148-5607 |
| Popis: | Background/aims Present meta-analysis aims to evaluate studies of low- versus high-dose proton pump Inhibitors (PPI) post-endoscopic hemostasis, including the newly published randomized controlled trials (RCTs) and to conclude whether low-dose PPI can generate the comparable results as high-dose PPI. Materials and methods To identify suitable trials, the electronic databases PubMed, Medline, Cochrane Library, and the Embase were used. All RCTs concerning low- versus high-dose PPI administration post-endoscopic hemostasis published until December 2016 were identified. Primary outcomes were rebleeding rates, need for surgical intervention, and mortality. Results Studies included a total of 1.651 participants. There were significantly less cases of rebleeding in the low-dose PPI treatment arm (p=0.003). All but one study provided data concerning need for Surgical Intervention and Mortality. The respective effect sizes were [odds ratio (OR), 95% confidence intervals (CI): 1.35, 0.72-2.53] and [OR, 95% CI: 1.20, 0.70-2.05]. Both treatment arms were comparable considering the aforementioned outcomes (p=0.35 and p=0.51, respectively). Meta-regression analysis likewise unveiled comparable outcomes between studies using pantoprazole versus lansoprazole concerning all three outcomes [rebleeding (p=0.944), surgical intervention (p=0.884), and mortality (p=0.961)]. Conclusion A low-dose PPI treatment is equally effective as a high-dose PPI treatment following endoscopic arresting of bleeding. However, we anticipate the completion of more high-quality RCTs that will embrace distinct ethnicities, standardized endoscopic diagnosis and management, double-blind strategies, and appraisal of results working specific standards over clear-cut follow-up periods. |
| Databáze: | OpenAIRE |
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