Proton pump inhibitors therapy vs H2 receptor antagonists therapy for upper gastrointestinal bleeding after endoscopy: A meta-analysis

Table 1 General condition sheet of the included studies

Ref.	Sample size	Age	Gender (M/F)	Smoking (%)	Alcohol abuse (%)	H. pylori infection positive (%)	NSAID user (%)	Drug type	Intervention		Outcome assessment time	The main outcomes
									PPI group	H2RA group
Hsu et al[13]	P:52	P: 63.2 ± 18.	P: 41/11	P: 32.7	P: 13.5	NA	P: 26.9	P: Pantoprazole	40 mg intravenous/12 h 3 d, followed by 40 mg/d orally	50 mg intravenous/8 h, followed by 150 mg/12 h orally	8 wk	12345
	H:50	H: 64.7 ± 13.8	H: 37/13	H: 32.0	H: 8.0		H: 320	H: Ranitidine
Ye et al[14]	P:41	P: 61.2 ± 9.0	P: 28/13	NA	NA	P: 61.0	NA	P: Omeprazole	20 mg/d orally	20 mg/12 h orally	28 d	1
	H:41	H: 58.5 ± 9.4	H: 24/17			H: 56.1		H: Famotidine
Jensen et al[15]	P:72	P: 59.6 ± 16.1	P: 51/21	NA	NA	NA	P: 69	P: Pantoprazole	80 mg bolus and 8 mg/h infusion 3 d	50 mg bolus and 6.25 mg/h infusion 3 d	3 d, 7 d, 30 d	1
	H:77	H: 55.6 ± 16.8	H: 52/25				H: 71	H: Ranitidine
Lin et al[16]	Pa:67	Pa: 67	Pa: 58/9	NA	NA	NA	Pa: 26.9	P: Omeprazole	a: 40 mg intravenous/12 h 3 d, followed by 20 mg/d orally	400 mg intravenous/12 h 3 d, followed by 400 mg/12 h orally	14 d	12345
	Pb:66	Pb: 71	Pb: 57/9				Pb: 24.2	H: Cimetidine	b: 40 mg intravenous/6 h 3 d, followed by 20 mg/d orally
	H:67	H: 68	H: 61/6				H: 29.9
Jeong et al[17]	P:85	P: 62.9 ± 9.4	P: 52/33	NA	NA	P: 61.9	NA	P: Pantoprazole	80 mg bolus and 8 mg/h infusion d1, 40 mg intravenous/12 h d2-3, followed by 40 mg/d orally	20 mg intravenous/12 h d2, followed by 20 mg/d orally	24 h, 7 d, 14 d	123
	H:79	H: 63.5 ± 7.8	H: 53/26			H: 64.1		H: Famotidine
Uedo et al[18]	P:64	P: 68.1 ± 8.5	112/33	NA	NA	11.5	11.5	P: Rabeprazole	20 mg/d orally	800 mg/d orally	8 wk	1
	H:66	H: 65.7± 7.6						H: Cimetidine
Imaeda et al[19]	P:62	P: 68.4 ± 8.0	P: 47/15	P: 58.1 H: 49.2	NA	P: 61.3	NA	P: Lansoprazole	30 mg intravenous/12 h 2 d, followed by 30 mg/d orally	75 mg intravenous/12 h 2 d, followed by 75 mg/12 h orally	8 wk	1
	H:61	H: 67.6 ± 8.5	H: 52/9			H: 62.3		H: Roxatidine
Sakurada et al[20]	P:40	P: 65.8 ± 2.5	P: 35/5	NA	NA	P: 77.5	P: 35.0	P: Omeprazole	20 mg intravenous/12 h 3 d, followed by 20 mg/d orally	20 mg intravenous/12 h 3 d, followed by 20 mg/d orally	6-8 wk	15
	H:37	H:60.2 ± 1.7	H: 31/6			H: 78.4	H: 29.7	H: Famotidine
Tomita et al[21]	P:77	P: 70.4 ± 8.7	P: 59/18	NA	NA	NA	NA	P: Omeprazole	20 mg/12 h intravenous 3 d, followed by 20 mg/d orally	40 mg bolus/d	8 wk	1
	H:79	H: 70.6 ± 9.5	H: 59/20					H: Famotidine
Lin et al[22]	P:50	P: 65 H: 66.5	P: 46/4	P: 34.0	P:12.0	NA	NA	P: Omeprazole	40 mg intravenous and 160 mg infusion 3 d, followed by 20 mg/12 h orally 2 m	300 mg intravenous and 1200 mg infusion 3 d, followed by 400 mg/12 h orally 2 m	3 d, 14 d	12345
	H:50		H:43/7	H: 28.0	H: 12.0			H: Cimetidine

¹Recurrent bleeding (n);

²Mortality (n);

³Received surgery (n);

⁴Blood transfused (unit);

⁵Hospital stay (d). P: PPI group; H: H₂RA group; PPI: Proton pump inhibitor; H₂RA: Histamine 2 receptor antagonist; NA: Not applicable.

Table 2 Subgroup analyses of recurrent bleeding rate

	Number of studies	Number of subjects	OR (95%CI)	Heterogeneity withinsubgroups	Difference betweensubgroups
End-point time
Overall	10	2076	0.33 (0.24-0.45)	No (P = 0.20, I2 = 23%)	No (P = 0.42, I2 = 0%)
24 h	1	164	0.08 (0.00-1.46)	NA
3 d	2	249	0.23 (0.07-0.76)	Yes (P = 0.13, I2 = 56%)
7 d	2	313	0.32 (0.13-0.79)	No (P = 0.37, I2 = 0%)
14 d	3	464	0.26 (0.16-0.43)	Yes (P = 0.07, I2 = 58%)
28-30 d	2	231	0.45 (0.15-1.36)	NA
6 wk or more	5	588	0.53 (0.30-0.94)	No (P = 0.42, I2 = 0%)
Nation
Overall	10	1283	0.36 (0.25-0.51)	No (P = 0.13, I2 = 35%)	No (P = 0.42, I2 = 0%)
Japan	4	486	0.63 (0.33-1.17)	No (P = 0.51, I2 = 0%)
China	3	402	0.25 (0.14-0.42)	Yes (P = 0.06, I2 = 59%)
South Korea	2	246	0.25 (0.07-0.95)	NA
United States	1	149	0.45 (0.15-1.36)	NA
Intervention drug PPI
Overall	8	1030	0.32 (0.21-0.48)	No (P = 0.13, I2 = 37%)	No (P = 0.93, I2 = 0%)
Omeprazole	5	615	0.32 (0.20-0.52)	Yes (P = 0.03, I2 = 61%)
Pantoprazole	3	415	0.31 (0.15-0.65)	No (P = 0.69, I2 = 0%)
Intervention drug H2RA
Overall	8	996	0.33 (0.22-0.48)	No (P = 0.14, I2 = 36%)	No (P = 0.18, I2 = 41.6%)
Cimetidine	3	430	0.27 (0.16-0.44)	Yes (P = 0.07, I2 = 58%)
Famotidine	3	315	0.85 (0.28-2.61)	No (P = 0.56, I2 = 0%)
Ranitidine	2	251	0.34 (0.14-0.85)	No (P = 0.45, I2 = 0%)

OR: Odds ratio; CI: Confidence interval; NA: Not applicable.