Short-term treatment of gastric ulcer. A meta-analytical evaluation of blind trials

Francesco Di Mario, Giuseppe Battaglia, Gioacchino Leandro, Giovanni Grasso, Fabio Vianello, Sergio Vigneri

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Abstract

Gastric ulcer is relatively infrequent, and clinical trials are often based on small-sized samples. The aim of this study was to define the 'gold standard' therapy of active gastric ulcer. We included all single- or double-blind clinical trials on the short-term treatment of gastric ulcer. All the articles published over the period 1977-1994 were reviewed. Meta-analysis was done with both fixed and random effect models; results were shown using Galbraith's radial plot. Forty-eight papers comprising 52 studies were evaluated. Cimetidine, ranitidine, and famotidine proved significantly better than placebo [odds ratio (PR) and 95% confidence interval (CI 95%) at four to six weeks were: 2.67 (2.03-3.52), 3.94 (2.28-6.50), 1.76 (1.08-2.88), respectively]. Cimetidine and ranitidine had results comparable with the newer H2 blockers [OR (CI 95%) at four weeks: 1.16 (0.91-1.47), 1.11 (0.80-1.55), respectively]. H2 blockers were proved comparable with either sucralfate [OR (CI 95%) at eight weeks: 0.81 (0.37-1.79)] or bismuth [OR (CI 95%) at four to six weeks: 0.67 (0.37-1.20)]. Omeprazole is more effective than H2 blockers [OR (CI 95%) at four weeks: 2.00 (1.57-2.55)]. It is concluded that H2 blockers are preferred to either a placebo or sucralfate for short-term gastric ulcer treatment; the newer H2 blockers do not have significant advantages over the older types; omeprazole can be regarded as the 'gold standard' for active gastric ulcer treatment.

Original languageEnglish
Pages (from-to)1108-1131
Number of pages24
JournalDigestive Diseases and Sciences
Volume41
Issue number6
DOIs
Publication statusPublished - 1996

Keywords

  • Gastric ulcer
  • H blockers
  • Meta-analysis
  • Omeprazole
  • Peptic ulcer therapy

ASJC Scopus subject areas

  • Gastroenterology

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