Oral vs. Intravenous Proton-Pump Inhibitors for Bleeding Peptic Ulcers

IV delivery of PPI therapy was not superior to oral delivery, but absence of superiority does not imply statistical equivalence or noninferiority.

High-dose proton-pump inhibitor (PPI) therapy is indicated in patients with bleeding peptic ulcers and high-risk stigmata (HRS) after endoscopic therapy. Intravenous (IV) PPI delivery has been shown to decrease rebleeding in this setting. But whether oral PPI delivery is as effective has been less clear.

To address this issue, investigators performed a meta-analysis of nine randomized controlled trials that compared clinical outcomes of intravenous versus oral PPI therapy in a total of 1036 patients with bleeding peptic ulcers following endoscopic management.

The pooled results showed no differences in rates of rebleeding (odds ratio, 0.93; 95% confidence interval, 0.60–1.46), surgery (OR, 0.77; 95% CI, 0.25–2.40), repeat endoscopy (OR, 0.69;…

Reviewing Author

David J. Bjorkman, MD, MSPH (HSA), SM (Epid.)

Disclosures

Nothing to disclose

David J. Bjorkman, MD, MSPH (HSA), SM (Epid.)

Disclosures

Nothing to disclose

Oral vs. Intravenous Proton-Pump Inhibitors for Bleeding Peptic Ulcers

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Reviewing Author