Zhixiang Jian1, Hui Li2, Nicholas S Race3, Tingting Ma4, Haosheng Jin1, Zi Yin1. 1. General Surgery Department of Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China. 2. Neurological Department of Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China. 3. Purdue University Weldon School of Biomedical Engineering, Indiana University School of Medicine, B.S. Biomedical Engineering, Rose-Hulman Institute of Technology, Terre Haute, IN, USA. 4. Gynaecology and Obstetrics Department, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Abstract
AIMS: Oral and intravenous proton pump inhibitors (PPIs) are equipotent in raising gastric pH. However, it is not known whether oral PPIs can replace intravenous PPIs in patients with bleeding peptic ulcers. METHODS: We conducted a systematic review and meta-analysis of randomized controlled trials to compare oral and intravenous PPIs among patients with peptic ulcer bleeding. A search of all major databases and relevant journals from inception to April 2015, without a restriction on languages, was performed. RESULTS: A total of 859 patients from seven randomized controlled trials were included in the meta-analysis. Similar pooled outcome measures were demonstrated between the two groups in terms of oral PPIs vs. intravenous PPIs in the rate of recurrent bleeding within the 30-day follow-up period [risk ratio = 0.90; 95% confidence interval (CI): 0.58, 1.39; P = 0.62; I(2) = 0%). In terms of the rate of mortality, both oral and intravenous PPIs showed similar outcomes, and the pooled risk ratio was 0.88 (95% CI: 0.29, 2.71; P = 0.82; I(2) = 0%). Likewise, no significant difference was detected in the need for blood transfusion and length of hospital stay; the pooled mean differences were -0.14 (95% CI: -0.39, 0.12; P = 0.29; I(2) = 32%) and -0.60 (95% CI: -1.42, 0.23; P = 0.16; I(2) = 79%), respectively. CONCLUSIONS: Our results suggest that oral PPIs are a feasible, safe alternative to intravenous PPIs in patients with bleeding peptic ulcers, and may be able to replace intravenous PPIs as the treatment of choice in these patients.
AIMS: Oral and intravenous proton pump inhibitors (PPIs) are equipotent in raising gastric pH. However, it is not known whether oral PPIs can replace intravenous PPIs in patients with bleeding peptic ulcers. METHODS: We conducted a systematic review and meta-analysis of randomized controlled trials to compare oral and intravenous PPIs among patients with peptic ulcer bleeding. A search of all major databases and relevant journals from inception to April 2015, without a restriction on languages, was performed. RESULTS: A total of 859 patients from seven randomized controlled trials were included in the meta-analysis. Similar pooled outcome measures were demonstrated between the two groups in terms of oral PPIs vs. intravenous PPIs in the rate of recurrent bleeding within the 30-day follow-up period [risk ratio = 0.90; 95% confidence interval (CI): 0.58, 1.39; P = 0.62; I(2) = 0%). In terms of the rate of mortality, both oral and intravenous PPIs showed similar outcomes, and the pooled risk ratio was 0.88 (95% CI: 0.29, 2.71; P = 0.82; I(2) = 0%). Likewise, no significant difference was detected in the need for blood transfusion and length of hospital stay; the pooled mean differences were -0.14 (95% CI: -0.39, 0.12; P = 0.29; I(2) = 32%) and -0.60 (95% CI: -1.42, 0.23; P = 0.16; I(2) = 79%), respectively. CONCLUSIONS: Our results suggest that oral PPIs are a feasible, safe alternative to intravenous PPIs in patients with bleeding peptic ulcers, and may be able to replace intravenous PPIs as the treatment of choice in these patients.
Authors: A Andriulli; V Annese; N Caruso; A Pilotto; L Accadia; A G Niro; M Quitadamo; A Merla; S Fiorella; G Leandro Journal: Am J Gastroenterol Date: 2005-01 Impact factor: 10.864
Authors: Weam El Hajj; Vincent Quentin; Gaelle Boudoux D'Hautefeuille; Helene Vandamme; Chantal Berger; Mohammed Redha Moussaoui; Aliou Berete; Dominique Louvel; Jean Guy Bertolino; Emmanuel Cuillerier; Quentin Thiebault; Yves Arondel; Sylvie Grimbert; Brigitte Le Guillou; Isabelle Borel; Pierre Lahmek; Stéphane Nahon Journal: United European Gastroenterol J Date: 2021-06-08 Impact factor: 4.623