Meta-analysis

The efficacy of intravenous H2-receptor antagonists in bleeding peptic ulcer

J. E. Levine, G. I. Leontiadis, V. K. Sharma, Colin Howden

Research output: Contribution to journalArticle

80 Citations (Scopus)

Abstract

Background: Although a previous meta-analysis found that intravenous H2-receptor antagonists were only weakly beneficial in bleeding gastric ulcer and of no benefit in bleeding duodenal ulcer, patients with ulcer bleeding continue to receive such treatment. Aim: To re-evaluate the efficacy of intravenous H2-receptor antagonists in ulcer re-bleeding, surgery and mortality by updating the previous meta-analysis. Methods: After two independent literature searches, randomized, placebo-controlled trials of intravenous H2-receptor antagonists in bleeding ulcer published between 1984 and 2000 were added to those from the initial meta-analysis. Pooled rates of re-bleeding, surgery and death were re-calculated, together with the relative risk reduction, absolute risk reduction, number needed to treat and Mantel-Haenszel odds ratio. Results: Intravenous H2-receptor antagonists did not significantly reduce re-bleeding, surgery or death in bleeding duodenal ulcer. There were small but significant reductions in re-bleeding, surgery and death in bleeding gastric ulcer; the absolute risk reductions were 7.2%, 6.7% and 3.2%, respectively. Conclusions: Intravenous H2-receptor antagonists are of no value in bleeding duodenal ulcer, although they may be mildly beneficial in bleeding gastric ulcer. Because proton pump inhibitors have a greater inhibitory effect on gastric acid secretion than H2-receptor antagonists, they may be more effective in ulcer bleeding and should be further evaluated for that indication.

Original languageEnglish (US)
Pages (from-to)1137-1142
Number of pages6
JournalAlimentary Pharmacology and Therapeutics
Volume16
Issue number6
DOIs
StatePublished - Jul 4 2002

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Histamine H2 Receptors
Peptic Ulcer
Meta-Analysis
Hemorrhage
Numbers Needed To Treat
Ulcer
Stomach Ulcer
Duodenal Ulcer
Proton Pump Inhibitors
Gastric Acid
Risk Reduction Behavior

All Science Journal Classification (ASJC) codes

  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

Meta-analysis : The efficacy of intravenous H2-receptor antagonists in bleeding peptic ulcer. / Levine, J. E.; Leontiadis, G. I.; Sharma, V. K.; Howden, Colin.

In: Alimentary Pharmacology and Therapeutics, Vol. 16, No. 6, 04.07.2002, p. 1137-1142.

Research output: Contribution to journalArticle

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