PPI efficacy in the reduction of variceal bleeding incidence and mortality, a meta-analysis
Department
Internal Medicine
Document Type
Article
Publication Title
The Egyptian Journal of Internal Medicine
Abstract
Objective: To review the efficacy and safety of proton pump inhibitors (PPIs) in gastroesophageal varices (GEVs).
Methods: We searched PubMed MEDLINE, Scopus, and Web of Science for studies that measured the effect of PPI for prophylaxis and treatment of post-band ligation ulcers up to July 20, 2021. We included studies that measured the effect of PPI as treatment or prophylaxis for post-band ligation ulcers; articles that were published in peer-reviewed international journals and had enough data for qualitative and quantitative analysis were included with no language restriction. Heterogeneity was evaluated using the inconsistency (I2) and chi-squared (χ2) test. I2 > 50% was considered substantial heterogeneity in the studies, and a P value less than 0.05 was considered statistically significant. The data was continuous, and we used the standardized mean difference (MD) and risk ratio (RR) with a 95% confidence interval to assess the estimated effect measure.
Results: A total of 7 studies with 2030 patients were included in our study of which 1480 participants were males (72%) and 550 females (18%). Mean age was 59.7 years old. Rebleeding post-band ligation was compared between PPI and placebo with significant favor for PPI (p = 0.00001). The pooled risk ratio was 0.53 (95% CI of 0.41, 0.68); furthermore, bleeding-related death at a 1-month period was compared between PPI and placebo with significant favor for PPI (p = 0.00001). The pooled risk ratio was significant at 0.33 (95% CI of 0.20, 0.53). The length of hospital stay postoperative was compared between PPI and placebo with cumulative mean difference of 0.13 (95% CI of −1.13, 1.39), yet without significance.
Conclusions: The study suggests a twofold reduction in the risk of bleeding and a threefold reduction in the risk of bleeding-related death with the use of PPI following EVL.
First Page
68
DOI
10.1186/s43162-022-00156-2
Volume
34
Publication Date
9-4-2022
Recommended Citation
Elseidy, S. A., Sayed, A., Awad, A. K., Mandal, D., Mostafa, M., Adigun, A., Vorla, M., Zamani, Z., & Iqbal, A. (2022). PPI efficacy in the reduction of variceal bleeding incidence and mortality, a meta-analysis. The Egyptian Journal of Internal Medicine, 34, 68. https://doi.org/10.1186/s43162-022-00156-2