Efficacy of Proton Pump Inhibitors for Patients With Duodenal Ulcers: A Pairwise and Network Meta-Analysis of Randomized Controlled Trials

Saudi J Gastroenterol. Jan-Feb 2017;23(1):11-19. doi: 10.4103/1319-3767.199117.

Abstract

Background/aim: To compare the efficacy and tolerance of different proton pump inhibitors (PPIs) in different doses for patients with duodenal ulcers.

Materials and methods: An electronic database was searched to collect all randomized clinical trials (RCTs), and a pairwise and network meta-analysis were performed.

Results: A total of 24 RCTs involving 6188 patients were included. The network meta-analysis showed that there were no significant differences for the 4-week healing rate of duodenal ulcer treated with different PPI regimens except pantoprazle 40 mg/d versus lansoprazole 15 mg/d [Relative risk (RR) = 3.57; 95% confidence interval (CI) = 1.36-10.31)] and lansoprazole 30 mg/d versus lansoprazole 15 mg/d (RR = 2.45; 95% CI = 1.01-6.14). In comparison with H2receptor antagonists (H2RA), pantoprazole 40 mg/d and lansoprazole 30 mg/d significantly increase the healing rate (RR = 2.96; 95% CI = 1.78-5.14 and RR = 2.04; 95% CI = 1.13-3.53, respectively). There was no significant difference for the rate of adverse events between different regimens, including H2RA for a duration of 4-week of follow up.

Conclusion: There was no significant difference for the efficacy and tolerance between the ordinary doses of different PPIs with the exception of lansoprazle 15 mg/d.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • 2-Pyridinylmethylsulfinylbenzimidazoles / administration & dosage
  • 2-Pyridinylmethylsulfinylbenzimidazoles / therapeutic use
  • Drug Administration Schedule
  • Duodenal Ulcer / drug therapy*
  • Humans
  • Lansoprazole / administration & dosage
  • Lansoprazole / therapeutic use
  • Network Meta-Analysis
  • Pantoprazole
  • Proton Pump Inhibitors / administration & dosage*
  • Proton Pump Inhibitors / therapeutic use
  • Randomized Controlled Trials as Topic
  • Treatment Outcome

Substances

  • 2-Pyridinylmethylsulfinylbenzimidazoles
  • Proton Pump Inhibitors
  • Lansoprazole
  • Pantoprazole