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Volume 7, Issue 6 (Suppl)
J Gastrointest Dig Syst, an open access journal
ISSN: 2161-069X
Page 60
December 07-08, 2017 Madrid, Spain
&
13
th
International Conference on Clinical Gastroenterology & Hepatology
2
nd
International Conference on Digestive Diseases
CO-ORGANIZED EVENT
Proton pump inhibitors for preventing non-steroidal anti-inflammatory drug induced gastrointestinal
toxicity: A systematic review
Ping Guang Lei, Jun Hui He, Man Yang, Jin Qing Ou
and
Tsz Leung Pun
Songgang People’s Hospital, China
Objective:
Proton pump inhibitors (PPIs) are recommended for preventing gastrointestinal lesions induced by non-steroidal
anti-inflammatory drugs (NSAIDs). We performed this study: (1) to evaluate the effectiveness and safety of PPIs, (2) to explore
the association between effectiveness and potential influential factors, and (3) to investigate the comparative effect of different
PPIs.
Methods:
MEDLINE, EMBASE, and the Cochrane Library were searched to identify randomized controlled trials comparing
different classes of PPIs, or comparing PPIs with placebo, H2 receptor antagonists or misoprostol in NSAIDs users. Both
pairwise meta-analysis and Bayesian network meta-analysis were performed.
Results:
Analyses were based on 12,532 participants from 31 trials. PPIs were significantly more effective than placebo in
reducing ulcer complications (relative risk [RR] ¼ 0.29; 95% confidence interval [CI], 0.20 to 0.42) and endoscopic peptic
ulcers (RR ¼ 0.27; 95% CI, 0.22 to 0.33), with no subgroup differences according to class of NSAIDs, ulcer risk, history of
previous ulcer disease, Helicobacter pylori infection, or age. To prevent one ulcer complication, 10 high risk patients and 268
moderate risk patients need PPI therapy. Network meta-analysis indicated that the effectiveness of different PPIs in reducing
ulcer complications and endoscopic peptic ulcers is generally similar. PPIs significantly reduced gastrointestinal adverse events
and the related withdrawals compared to placebo; there is no difference in safety between different PPIs.
Conclusions:
PPIs are effective and safe in preventing peptic ulcers and complications in a wide spectrum of patients requiring
NSAID therapy. There is no major difference in the comparative effectiveness and safety between different PPIs.
18002575273@163.comJ Gastrointest Dig Syst 2017, 7:6(Suppl)
DOI: 10.4172/2161-069X-C1-059