A201 efficacy of proton pump inhibitor plus mucoprotective agent for endoscopic submucosal dissection-derived ulcer; a systematic review and meta-analysis of randomized control trial
Abstract
Currently, it is still unclear whether adding a mucoprotective agent to a Proton Pump Inhibitor (PPI) (combination treatment) results in better outcomes compared to using a PPI alone, in term of both ulcer healing and delayed bleeding in patients with post gastric-endoscopic submucosal dissection (ESD) ulcers. We conducted a meta-analysis of randomized control trials examining the efficacy of PPI alone versus combination treatment in post gastric-ESD ulcer healing as well as delayed bleeding. We performed a systematic search of MEDLINE, EMBASE, Cochrane, and ISI Web of knowledge databases, up until May 2017, for randomized trials (RCTs) comparing PPI alone versus PPI plus a mucoprotective drug in achieving ulcer healing in patients undergoing gastric ESD. Medical subject headings and keywords included PPI (omeprazole, esomeprazole, lansoprazole, dexlansoprazole, pantoprazole and rabeprazole) and mucoprotective agents (rebamipide and sucralfate). Pediatrics trials, non human subjects, not fully published articles or non-English publications were excluded. The primary outcome is scaring stage (S1 or S2) on endoscopic assessment at 4 weeks or 8 weeks after gastric ESD. Preplanned subgroup and sensitivity analyses were performed. A meta-analysis was conducted using random effect models with results reported as risk-ratios (RR) with 95% confidence intervals. Heterogeneity and publication bias were assessed and quantified. From an initial 2250 citations, seven articles with 897…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 897 participants or records.
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