Investigators from Greece and the USA conducted a meta-analysis to evaluate the efficacy of intravenous H2-receptor antagonists in the treatment of bleeding peptic ulcer.
A previous meta-analysis found that intravenous H2-receptor antagonists were only weakly beneficial in bleeding gastric ulcer, and of no benefit in bleeding duodenal ulcer.
However, patients with ulcer bleeding continue to receive such treatment.
Two independent literature searches identified randomized, placebo-controlled trials of intravenous H2-receptor antagonists in bleeding ulcer, published between 1984 and 2000.
These were added to the studies from the initial meta-analysis.
| H2-receptor antagonists had no effect on bleeding duodenal ulcer.
| Alimentary Pharmacology & Therapeutics |
Pooled rates of re-bleeding, surgery, and death were re-calculated.
The group found that intravenous H2-receptor antagonists did not significantly reduce re-bleeding, surgery, or death in bleeding duodenal ulcer.
However, there were small, but significant, reductions in re-bleeding, surgery, and death in bleeding gastric ulcer.
The absolute risk reductions were 7.2%, 6.7%, and 3.2%, respectively.
Dr J. E. Levine, of Evanston Hospital, Illinois, USA, said on behalf of fellow authors, "Intravenous H2-receptor antagonists are of no value in bleeding duodenal ulcer, although they may be mildly beneficial in bleeding gastric ulcer."
"As proton pump inhibitors have a greater inhibitory effect on gastric acid secretion than H2-receptor antagonists, they may be more effective in ulcer bleeding and should be further evaluated for that indication," it was concluded.