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High-dose vs low-dose proton pump inhibitors for upper gastrointestinal bleeding: a meta-analysis.
- Source :
-
World journal of gastroenterology [World J Gastroenterol] 2010 May 28; Vol. 16 (20), pp. 2558-65. - Publication Year :
- 2010
-
Abstract
- Aim: To evaluate the efficacy of high-dose proton pump inhibitors (PPIs) vs low-dose PPIs for patients with upper gastrointestinal bleeding.<br />Methods: PubMed, Embase, the Cochrane Library, and Web of Science were searched to identify relevant randomized controlled trials (RCTs). Eligible trials were RCTs that compared high-dose PPI with low-dose PPI following endoscopic hemostasis. The primary endpoint was rebleeding; secondary endpoints were patient numbers that needed surgery, and mortality. The meta-analysis was performed with a fixed effects model or random effects model.<br />Results: Nine eligible RCTs including 1342 patients were retrieved. The results showed that high-dose intravenous PPI was not superior to low-dose intravenous PPI in reducing rebleeding [odds ratio (OR) = 1.091, 95% confidential interval (CI): 0.777-1.532], need for surgery (OR = 1.522, 95% CI: 0.643-3.605) and mortality (OR = 1.022, 95% CI: 0.476-2.196). Subgroup analysis according to different region revealed no difference in rebleeding rate between Asian patients (OR = 0.831, 95% CI, 0.467-1.480) and European patients (OR = 1.263, 95% CI: 0.827-1.929).<br />Conclusion: Low-dose intravenous PPI can achieve the same efficacy as high-dose PPI following endoscopic hemostasis.
- Subjects :
- Databases, Factual
Dose-Response Relationship, Drug
Gastrointestinal Hemorrhage mortality
Gastrointestinal Hemorrhage prevention & control
Gastrointestinal Hemorrhage surgery
Hemostasis, Endoscopic
Humans
Randomized Controlled Trials as Topic
Recurrence
Upper Gastrointestinal Tract surgery
Gastrointestinal Hemorrhage drug therapy
Proton Pump Inhibitors therapeutic use
Upper Gastrointestinal Tract pathology
Subjects
Details
- Language :
- English
- ISSN :
- 2219-2840
- Volume :
- 16
- Issue :
- 20
- Database :
- MEDLINE
- Journal :
- World journal of gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 20503458
- Full Text :
- https://doi.org/10.3748/wjg.v16.i20.2558