Comparison of different regimens of proton pump inhibitors for acute peptic ulcer bleeding

Perforated and bleeding peptic ulcer: WSES guidelines

“…Similar results were found by meta-analysis; high-dose intravenous PPIs after endoscopic therapy significantly reduced rebleeding, need for surgery, and mortality compared with placebo/no therapy [119]. On the other hand, a Cochrane review [120] focusing on this topic and including twenty-two RCTs found insufficient evidence to conclude superiority, inferiority, or equivalence of highdose PPI treatment over lower doses in peptic ulcer bleeding. Another systematic review from the Cochrane Collaboration [121] included six RCTs comprising 2223 patients and showed that PPI treatment initiated before endoscopy for upper gastrointestinal bleeding might reduce the proportion of patients with stigmata of recent bleeding at index endoscopy and significantly reduces the requirement for endoscopic therapy during index endoscopy.…”

Perforated and bleeding peptic ulcer: WSES guidelines

“…Similar results were found by meta-analysis; high-dose intravenous PPIs after endoscopic therapy significantly reduced rebleeding, need for surgery, and mortality compared with placebo/no therapy [119]. On the other hand, a Cochrane review [120] focusing on this topic and including twenty-two RCTs found insufficient evidence to conclude superiority, inferiority, or equivalence of highdose PPI treatment over lower doses in peptic ulcer bleeding. Another systematic review from the Cochrane Collaboration [121] included six RCTs comprising 2223 patients and showed that PPI treatment initiated before endoscopy for upper gastrointestinal bleeding might reduce the proportion of patients with stigmata of recent bleeding at index endoscopy and significantly reduces the requirement for endoscopic therapy during index endoscopy.…”

Clinical outcomes of esophagogastroduodenoscopy in critically ill patients using high-dose proton pump inhibitor for suspected bleeding

“…between high-dose and non-high-dose PPIs, high-dose PPI treatment seems to be tolerable in critically ill patients, considering that an indirect comparison study yielded the superiority of high-dose PPI therapy; adverse effects of highdose PPI were poorly reported in most studies. [11,12] In this study as well, no critical adverse events such as thrombophlebitis or discontinuous infusion was reported. EGD is a useful tool for controlling acute GI bleeding and has diagnostic and therapeutic purposes.…”

“…In acute GI bleeding, PPI therapy showed reduced rates of mortality and re-bleeding risk compared to control treatment (placebo or histamine 2 receptor antagonists) (odds ratio, 0.56 [confidence intervals, 0.34–0.94] and 0.43 [0.29–0.63], respectively) [7] . Although 1 meta-analysis did not show any differences in the risk for mortality or re-bleeding between high-dose and non-high-dose PPIs, high-dose PPI treatment seems to be tolerable in critically ill patients, considering that an indirect comparison study yielded the superiority of high-dose PPI therapy; adverse effects of high-dose PPI were poorly reported in most studies [11,12] . In this study as well, no critical adverse events such as thrombophlebitis or discontinuous infusion was reported.…”

Comparative Analysis of Continuous versus Intermittent Proton Pump Inhibitor Therapy in Patients with Upper Gastrointestinal Bleeding Due to Ulcers

“…The prevailing hypothesis for utilizing high-dose Proton Pump Inhibitor By summarizing above the data of our analysis, we see how recommendations regarding high vs. low PPI regimen changed over time: from no difference in re-gimen in 2010 [12] to recommending continuous regimen in 2012 [13] to declaring insufficient evidence between choosing one regimen over another in 2013 [14] to determine that both regimens are comparable to each other in 2014 [15] and 2018 [16] and finally to recommending both regimens in 2021 [17].…”

“…Cochrane's systematic review by Neumann I et al, published in June 2013, concluded that the evidence was insufficient to determine the superiority, inferiority, or equivalence of high-dose PPI treatment compared to lower doses in peptic ulcer bleeding [14]. 22 RCTs were included; the risk of bias was high in 17 and unclear in 5.…”

Perforated and bleeding peptic ulcer: WSES guidelines

“…Similar results were found by meta-analysis; high-dose intravenous PPIs after endoscopic therapy significantly reduced rebleeding, need for surgery, and mortality compared with placebo/no therapy [119]. On the other hand, a Cochrane review [120] focusing on this topic and including twenty-two RCTs found insufficient evidence to conclude superiority, inferiority, or equivalence of highdose PPI treatment over lower doses in peptic ulcer bleeding. Another systematic review from the Cochrane Collaboration [121] included six RCTs comprising 2223 patients and showed that PPI treatment initiated before endoscopy for upper gastrointestinal bleeding might reduce the proportion of patients with stigmata of recent bleeding at index endoscopy and significantly reduces the requirement for endoscopic therapy during index endoscopy.…”

Clinical outcomes of esophagogastroduodenoscopy in critically ill patients using high-dose proton pump inhibitor for suspected bleeding

“…between high-dose and non-high-dose PPIs, high-dose PPI treatment seems to be tolerable in critically ill patients, considering that an indirect comparison study yielded the superiority of high-dose PPI therapy; adverse effects of highdose PPI were poorly reported in most studies. [11,12] In this study as well, no critical adverse events such as thrombophlebitis or discontinuous infusion was reported. EGD is a useful tool for controlling acute GI bleeding and has diagnostic and therapeutic purposes.…”

“…In acute GI bleeding, PPI therapy showed reduced rates of mortality and re-bleeding risk compared to control treatment (placebo or histamine 2 receptor antagonists) (odds ratio, 0.56 [confidence intervals, 0.34–0.94] and 0.43 [0.29–0.63], respectively) [7] . Although 1 meta-analysis did not show any differences in the risk for mortality or re-bleeding between high-dose and non-high-dose PPIs, high-dose PPI treatment seems to be tolerable in critically ill patients, considering that an indirect comparison study yielded the superiority of high-dose PPI therapy; adverse effects of high-dose PPI were poorly reported in most studies [11,12] . In this study as well, no critical adverse events such as thrombophlebitis or discontinuous infusion was reported.…”

Comparative Analysis of Continuous versus Intermittent Proton Pump Inhibitor Therapy in Patients with Upper Gastrointestinal Bleeding Due to Ulcers

“…The prevailing hypothesis for utilizing high-dose Proton Pump Inhibitor By summarizing above the data of our analysis, we see how recommendations regarding high vs. low PPI regimen changed over time: from no difference in re-gimen in 2010 [12] to recommending continuous regimen in 2012 [13] to declaring insufficient evidence between choosing one regimen over another in 2013 [14] to determine that both regimens are comparable to each other in 2014 [15] and 2018 [16] and finally to recommending both regimens in 2021 [17].…”

“…Cochrane's systematic review by Neumann I et al, published in June 2013, concluded that the evidence was insufficient to determine the superiority, inferiority, or equivalence of high-dose PPI treatment compared to lower doses in peptic ulcer bleeding [14]. 22 RCTs were included; the risk of bias was high in 17 and unclear in 5.…”

Perforated and bleeding peptic ulcer: WSES guidelines

“…Similar results were found by meta-analysis; high-dose intravenous PPIs after endoscopic therapy significantly reduced rebleeding, need for surgery, and mortality compared with placebo/no therapy [119]. On the other hand, a Cochrane review [120] focusing on this topic and including twenty-two RCTs found insufficient evidence to conclude superiority, inferiority, or equivalence of highdose PPI treatment over lower doses in peptic ulcer bleeding. Another systematic review from the Cochrane Collaboration [121] included six RCTs comprising 2223 patients and showed that PPI treatment initiated before endoscopy for upper gastrointestinal bleeding might reduce the proportion of patients with stigmata of recent bleeding at index endoscopy and significantly reduces the requirement for endoscopic therapy during index endoscopy.…”

Clinical outcomes of esophagogastroduodenoscopy in critically ill patients using high-dose proton pump inhibitor for suspected bleeding

“…between high-dose and non-high-dose PPIs, high-dose PPI treatment seems to be tolerable in critically ill patients, considering that an indirect comparison study yielded the superiority of high-dose PPI therapy; adverse effects of highdose PPI were poorly reported in most studies. [11,12] In this study as well, no critical adverse events such as thrombophlebitis or discontinuous infusion was reported. EGD is a useful tool for controlling acute GI bleeding and has diagnostic and therapeutic purposes.…”

“…In acute GI bleeding, PPI therapy showed reduced rates of mortality and re-bleeding risk compared to control treatment (placebo or histamine 2 receptor antagonists) (odds ratio, 0.56 [confidence intervals, 0.34–0.94] and 0.43 [0.29–0.63], respectively) [7] . Although 1 meta-analysis did not show any differences in the risk for mortality or re-bleeding between high-dose and non-high-dose PPIs, high-dose PPI treatment seems to be tolerable in critically ill patients, considering that an indirect comparison study yielded the superiority of high-dose PPI therapy; adverse effects of high-dose PPI were poorly reported in most studies [11,12] . In this study as well, no critical adverse events such as thrombophlebitis or discontinuous infusion was reported.…”

Comparative Analysis of Continuous versus Intermittent Proton Pump Inhibitor Therapy in Patients with Upper Gastrointestinal Bleeding Due to Ulcers

“…The prevailing hypothesis for utilizing high-dose Proton Pump Inhibitor By summarizing above the data of our analysis, we see how recommendations regarding high vs. low PPI regimen changed over time: from no difference in re-gimen in 2010 [12] to recommending continuous regimen in 2012 [13] to declaring insufficient evidence between choosing one regimen over another in 2013 [14] to determine that both regimens are comparable to each other in 2014 [15] and 2018 [16] and finally to recommending both regimens in 2021 [17].…”

“…Cochrane's systematic review by Neumann I et al, published in June 2013, concluded that the evidence was insufficient to determine the superiority, inferiority, or equivalence of high-dose PPI treatment compared to lower doses in peptic ulcer bleeding [14]. 22 RCTs were included; the risk of bias was high in 17 and unclear in 5.…”