Clinical Research
Copyright ©The Author(s) 2005.
World J Gastroenterol. Jul 14, 2005; 11(26): 4067-4077
Published online Jul 14, 2005. doi: 10.3748/wjg.v11.i26.4067
Table 1 Healing rate of esophagitis by ITT with standard dose vs high dose of H2RA at 3, 4, 6, 8, 12 wk
3-wk4-wk6-wk8-wk12-wk
Number of comparisons159512
High dosePooled data29/169297/669607/1 294413/6691 142/1 729
Pooled healing rate (%)17.244.446.961.766.0
Standard dosePooled data33/168198/573584/1 361309/573920/1 520
Pooled healing rate (%)19.634.642.953.960.5
Summary RR0.8741.2811.0961.1651.084
95% CI0.557-1.3711.036-1.5830.930-1.2931.020-1.3291.019-1.152
Table 2 Healing rate of esophagitis by ITT at 2, 3, 4, 8, 12 wk comparing proton pump inhibitors (PPIs) with H2RA
PPIs
H2RA
2-wk4-wk8-wk12-wk2-wk4-wk8-wk12-wk
sd PPIs vs sd H2RA
Number of arms2131221312
Pooled data116/183577/824640/78360/163271/713350/673
Pooled healing rate (%)63.470.081.736.838.052.0
Summary RR1.7591.8321.586
95%CI1.398-2.2131.622-2.0701.438-1.749
hd PPIs vs sd H2RA
Number of arms441441
Pooled data150/204175/20172/8079/211106/20749/81
Pooled healing rate (%)73.587.190.037.451.260.5
Summary RR1.7221.6231.488
95%CI1.464-2.0271.417-1.8591.230-1.800
sd PPIs vs hd H2RA
Number of arms2222
Pooled data152/235208/23587/234155/234
Pooled healing rate (%)64.788.537.266.2
Summary RR1.7441.336
95%CI1.442-2.1101.206-1.481
ld PPIs vs sd H2RA
Number of arms3333
Pooled data187/279219/279120/276161/276
Pooled healing rate (%)67.078.543.558.3
Summary RR1.6051.374
95%CI1.156-2.2291.081-1.744
Table 3 Healing rate (ITT) of esophagitis at 2, 4, 8 wk comparing PPIs with omeprazole
Other PPIs
Omeprazole
2-wk4-wk8-wk2-wk4-wk8-wk
sd PPIs vs sd Omeprazole
Number of arms1121211212
Pooled data264/4212 615/3 4123 050/3 411257/4312 229/3 2172 719/3 216
Pooled healing rate (%)62.776.689.459.669.384.5
Summary RR1.0521.0441.061
95%CI0.945–1.1710.983-1.1090.979-1.055
ld PPIs vs sd Omeprazole
Number of arms2222
Pooled data590/822724/822551/811707/811
Pooled healing rate (%)71.888.167.987.2
Summary RR1.026 0.981
95%CI0.904-1.1640.870-1.105
sd PPIs vs hd Omeprazole
Number of arms2121
Pooled data310/440284/337302/434282/332
Pooled healing rate (%)70.584.369.684.9
Summary RR1.0310.985
95%CI0.937-1.0150.883-1.099
Table 4 Healing rate of refractory esophagitis at 2, 4, 6, 8, 12 wk comparing PPIs with H2RA
AuthorPPIs
H2RAs
Number of
Healing rate ( ITT )
Number of
Healing rate ( ITT )
DrugDosePatient4 wk8 wk12 wkDrugDosePatient4 wk8 wk12 wk
sd PPIs vs sd H2RA
Feldman (55)Lan30 o.d.6154/61Ran150 b.d.3212/32
Sontag (56)Lan30 o.d.10575/10584/105Ran150 b.d.5428/5416/541
Pooled data16675/105138/1668628/5428/86
Pooled rate (%)71.483.151.932.6
hd PPIs vs hd H2RA
Lundell (57)Ome40 o.d.5132/5135/5146/51Ran300 b.d.478/4718/4722/47
Table 5 Healing by grade with standard dose vs high dose of H2RA at 4, 6, 8, 12 wk (PP rate)
4-wk
6-wk
8-wk
12-wk
IIIIIIIIIIIIIIIIIIIIII
Number of arms3344433466
Standard dosePooled data84/19022/10586/137102/26642/180126/18737/105107/129264/383119/256
Pooled rate (%)44.221.062.838.323.367.435.282.969.046.5
High dosePooled data177/32560/198112/157120/27260/214226/32392/198122/153400/532190/376
Pooled rate (%)54.430.371.344.128.070.046.579.775.250.5
Summary RR
95% CI1.2311.4301.1361.1501.2001.0391.3160.9621.0321.059
1.020-1.4860.941-2.2020.966-1.3370.939-1.4080.854-1.6860.919-1.1740.977-1.7740.860-1.0760.961-1.1080.913-1.229
Table 6 Healing by grade at 4, 8, 12 wk comparing PPIs with H2RAs (PP rate)
4 wk
8 wk
12 wk
IIIIIIIVIIIIIIIVIII
Number of arms2432531
sd PPIsPooled data53/60128/16220/5423/23166/17828/472/3
Pooled rate (%)88.379.037.0100.093.359.666.7
sd H2RAsPooled data27/5465/1722/4116/25101/1826/340/2
Pooled rate (%)50.037.84.964.055.517.60
Summary RR1.7602.0375.5881.5021.6482.7662.525
95%CI1.329-2.3321.631-2.5451.701-18.3631.107-2.0381.440-1.8851.284-5.9161.046-6.093
No. of arms24224211
hd PPIsPooled data40/4688/12321/3046/46104/12024/3029/2942/46
Pooled rate (%)87.071.570.0100.086.780.0100.091.3
sd H2RAsPooled data26/5049/1263/2837/4962/1216/2828/3219/35
Pooled rate (%)52.038.910.775.551.221.487.554.3
Summary RR1.6651.8356.1101.3001.6893.6261.1111.676
95%CI1.248-2.2221.436-2.3452.138-17.4591.102-1.5341.400-2.0361.772-7.4180.957-1.2911.222-2.298
Number of arms211211
ld PPIsPooled data144/17534/429/28162/17542/4415/28
Pooled rate (%)82.381.032.192.695.553.6
sd H2RAsPooled data104/17515/501/22132/17527/492/21
Pooled rate (%)59.430.04.575.455.19.5
Summary RR1.3842.6987.0711.2271.7325.625
95%CI1.202-1.5921.724-4.2240.967-51.7071.116-1.3491.335-2.2491.440-21.980
Refractory esophagitis
Number of arms11212
sd PPIsPooled data62/7711/22105/11613/1518/29
Pooled rate (%)80.550.090.586.762.1
sd H2RAsPooled data20/401/1126/612/80/14
Pooled rate (%)50.09.142.625.00
Summary RR1.6065.5002.1173.22935.881
95%CI1.158-2.2280.835-25.3371.575-2.8451.034-10.0910.728-1767.6
Table 7 Healing by grade at 4, 8 wk comparing standard dose of other PPIs vs omeprazole
4-wk
8-wk
IIIIIIIVIIIIIIIV
Number of arms33313331
sd PPIsPooled data195/239302/362148/2103/7214/235329/360175/2092/4
Pooled rate (%)81.683.470.542.991.191.483.750.0
sd omeprazolePooled data190/238315/393132/1953/5214/233345/390159/1881/2
Pooled rate (%)79.880.267.860.091.888.584.650.0
Summary RR1.0221.0411.0410.7330.9921.0330.9901.000
95%CI0.936-1.1160.973-1.1130.914-1.1860.250-2.1470.938-1.0480.985-1.0840.927-1.0570.213-4.694