Meta-analysis of proton pump inhibitor for preventing recurrence of non-steroidal anti-inflammatory drags-induced ulcers
10.3760/cma.j.issn.0254-1432.2009.07.010
- VernacularTitle:质子泵抑制剂预防非甾体类抗炎药相关性溃疡复发的荟萃分析
- Author:
Ying ZHANG
;
Shiyao CHEN
;
Jianfeng YAO
;
Lijun WU
;
Jian ZOU
;
Xiaofeng YU
- Publication Type:Journal Article
- Keywords:
Proton pump inhibitors;
Anti-inflammatory agents,non-steroidal;
Randomizedcontrolled trials as topic;
Meta-analysis
- From:
Chinese Journal of Digestion
2009;29(7):471-475
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the clinical efficacy and safety of proton pump inhibitors (PPI)for preventing recurrence of non-steroidal anti-inflammatory drugs (NSAIDs)-indueed upper gastrointestinal ulcers using meta-analysis. Methods Mono- or multicenter randomized controlled clinical trials related to NSAIDs-indueed ulcers were retrieved from database of China Biological Medicine and Medline from 1966 to 2007. The data were analyzed by RevMan 4. 2 software using random or fixed effects model. Results Ten randomized controlled trials including 3361 patients were included, The recta-analysis revealed that PPI treatment significantly reduced the recurrent rate of NSAIDs-associated ulcers (8. 7%) in comparison with controls (17. 2%, P = 0. 03). Those who received esomeprazole (4. 4%) or lansoprazole (18. 0%) had a low recurrence of peptic ulcers compared with controls (14.7% or 28.7%, P value= 0.01 or 0.05). But there was no significant differencebetween omeprazole and controls (P= 0. 16). The recurrence of NSAIDs-associated ulcers in patients treated with esomeprazole 20 mg or 40 mg and tansoprazole 15 mg were 4.4%, 4.3% and 19.7 % respectively. The stratify analysis showed that PPI therapy could effectively reduce recurrentce of non-selective NSAIDs-induced ulcer (P= 0. 009), but failed to selective cyclooxygenase (COX)-2 inhibitor induced ulcer. No severe adverse reactions were found in PPI groups. Conclusion PPI is effective and safe in prevention of NSAIDs-related ulcers without discontinuation of NSAIDs.
