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PPI versus Histamine H2 Receptor Antagonists for Prevention of Upper Gastrointestinal Injury Associated with Low-Dose Aspirin: Systematic Review and Meta-analysis.

Mo C, Sun G, Wang YZ, Lu ML, Yang YS - PLoS ONE (2015)

Bottom Line: We included nine RCTs involving 1047 patients.In conclusion, PPIs were superior to H2RAs for prevention of LDA-related GI erosion/ulcer and bleeding.Higher quality, large, multicenter RCTs are needed to demonstrate the preventive effect of the two acid-suppressive drugs.

View Article: PubMed Central - PubMed

Affiliation: Institute of Digestive Diseases, Chinese PLA General Hospital, Beijing 100853, China; Cadre Ward No. 2, the General Hospital of Chinese Armed Force Police, Beijing 100039, China.

ABSTRACT
This study compared proton pump inhibitors (PPIs) and histamine H2 receptor antagonists (H2RAs) for prevention of low-dose aspirin (LDA)-related gastrointestinal (GI) erosion, ulcer and bleeding. Electronic databases including PubMed, Embase, Cochrane Central Register of Controlled Trials, Chinese National Knowledge Infrastructure, Chinese Biomedical Literature Database, and WanFang Data were searched from the date of their establishment to December 31, 2013. Randomized controlled trials comparing PPIs and H2RAs for prevention of GI injury associated with low-dose aspirin (LDA) were collected. Two reviewers independently abstracted studies and patient characteristics and appraised study quality using the Cochrane risk-of-bias tool. Meta-analysis was performed using RevMan 5.1 software. We included nine RCTs involving 1047 patients. The meta-analysis showed that PPIs were superior to H2RAs for prevention of LDA-associated GI erosion/ulcer [odds ratio (OR=0.28, 95% confidence interval (CI): 0.16-0.50] and bleeding (OR=0.28, 95% CI: 0.14-0.59). In conclusion, PPIs were superior to H2RAs for prevention of LDA-related GI erosion/ulcer and bleeding. Higher quality, large, multicenter RCTs are needed to demonstrate the preventive effect of the two acid-suppressive drugs.

No MeSH data available.


Related in: MedlinePlus

PPIs and H2RAs for prevention of LDA-associated GI bleeding.
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pone.0131558.g005: PPIs and H2RAs for prevention of LDA-associated GI bleeding.

Mentions: Six of the eight included studies reported the incidence of LDA-associated GI bleeding in the PPI and H2RA groups. There was no statistical heterogeneity among the results (I2 = 6%, P = 0.38) and a fixed-effect model was used for meta-analysis. The result showed that PPIs were superior to H2RAs (OR = 0.28 95%CI: 0.14–0.59) for prevention of LDA-associated GI bleeding (Fig 5).


PPI versus Histamine H2 Receptor Antagonists for Prevention of Upper Gastrointestinal Injury Associated with Low-Dose Aspirin: Systematic Review and Meta-analysis.

Mo C, Sun G, Wang YZ, Lu ML, Yang YS - PLoS ONE (2015)

PPIs and H2RAs for prevention of LDA-associated GI bleeding.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4493004&req=5

pone.0131558.g005: PPIs and H2RAs for prevention of LDA-associated GI bleeding.
Mentions: Six of the eight included studies reported the incidence of LDA-associated GI bleeding in the PPI and H2RA groups. There was no statistical heterogeneity among the results (I2 = 6%, P = 0.38) and a fixed-effect model was used for meta-analysis. The result showed that PPIs were superior to H2RAs (OR = 0.28 95%CI: 0.14–0.59) for prevention of LDA-associated GI bleeding (Fig 5).

Bottom Line: We included nine RCTs involving 1047 patients.In conclusion, PPIs were superior to H2RAs for prevention of LDA-related GI erosion/ulcer and bleeding.Higher quality, large, multicenter RCTs are needed to demonstrate the preventive effect of the two acid-suppressive drugs.

View Article: PubMed Central - PubMed

Affiliation: Institute of Digestive Diseases, Chinese PLA General Hospital, Beijing 100853, China; Cadre Ward No. 2, the General Hospital of Chinese Armed Force Police, Beijing 100039, China.

ABSTRACT
This study compared proton pump inhibitors (PPIs) and histamine H2 receptor antagonists (H2RAs) for prevention of low-dose aspirin (LDA)-related gastrointestinal (GI) erosion, ulcer and bleeding. Electronic databases including PubMed, Embase, Cochrane Central Register of Controlled Trials, Chinese National Knowledge Infrastructure, Chinese Biomedical Literature Database, and WanFang Data were searched from the date of their establishment to December 31, 2013. Randomized controlled trials comparing PPIs and H2RAs for prevention of GI injury associated with low-dose aspirin (LDA) were collected. Two reviewers independently abstracted studies and patient characteristics and appraised study quality using the Cochrane risk-of-bias tool. Meta-analysis was performed using RevMan 5.1 software. We included nine RCTs involving 1047 patients. The meta-analysis showed that PPIs were superior to H2RAs for prevention of LDA-associated GI erosion/ulcer [odds ratio (OR=0.28, 95% confidence interval (CI): 0.16-0.50] and bleeding (OR=0.28, 95% CI: 0.14-0.59). In conclusion, PPIs were superior to H2RAs for prevention of LDA-related GI erosion/ulcer and bleeding. Higher quality, large, multicenter RCTs are needed to demonstrate the preventive effect of the two acid-suppressive drugs.

No MeSH data available.


Related in: MedlinePlus