Histamine H2 receptor antagonists for decreasing gastrointestinal harms in adults using acetylsalicylic acid: systematic review and meta-analysis.

摘要: Background: It is unclear if histamine H 2 receptor antagonists (H blockers) prevent a variety of gastrointestinal harms among patients taking acetylsalicylic acid (ASA) over long periods. Methods: Electronic databases (e.g., MEDLINE, Embase and Cochrane Central Register Controlled Trials; from inception to November 2010) reference lists retrieved articles were searched. Randomized placebo-controlled trials (RCTs) assessing the efficacy blockers in reducing (bleeding, ulcers) adults ASA for weeks or longer included. Two reviewers independently abstracted study patient characteristics appraised quality using risk-of-bias tool. Peto odds ratio (OR) meta-analysis was performed, 95% confidence intervals (CIs) calculated, statistical heterogeneity assessed I χ statistics. Results: Six RCTs (4 major publications companion reports) with total 498 participants (healthy volunteers arthritis, cardiovascular cerebrovascular disease, diabetes mellitus) One trial adequately reported allocation concealment sequence generation, other 3 being judged as both aspects. In one RCT, no statistically significant differences hemorrhage requiring admission hospital ( p = 0.14) blood transfusion 0.29) observed between group receiving concomitant famotidine placebo ASA. After median 8 weeks’ follow-up, more effective than (2 RCTs, 447 patients, OR 0.07, CI 0.02–0.23) peptic ulcers (3 465 0.21, 0.12–0.36) longer. Despite substantial clinical across studies, including types blockers, dosing underlying conditions, observed. Interpretation: reduced harm These results should be interpreted caution, because small number studies identified inclusion.