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The Role of Acid Suppressants in the Prevention of Anticoagulant-Related Gastrointestinal Bleeding: A Systematic Review and Meta-Analysis
- Title
- The Role of Acid Suppressants in the Prevention of Anticoagulant-Related Gastrointestinal Bleeding: A Systematic Review and Meta-Analysis
- Authors
- Bang, Chang Seok; Joo, Moon Kyung; Kim, Byung-Wook; Kim, Joon Sung; Park, Chan Hyuk; Ahn, Ji Yong; Lee, Jeong Hoon; Lee, Bong Eun; Yang, Hyo-Joon; Cho, Yu Kyung; Park, Jae Myung; Kim, Beom Jin; Jung, Hye-Kyung|Korean Coll Helicobacter Upper Gas
- Ewha Authors
- 정혜경
- SCOPUS Author ID
- 정혜경
- Issue Date
- 2020
- Journal Title
- GUT AND LIVER
- ISSN
- 1976-2283
2005-1212
- Citation
- GUT AND LIVER vol. 14, no. 1, pp. 57 - 66
- Keywords
- Anticoagulants; Acid suppressants; Gastrointestinal hemorrhage
- Publisher
- EDITORIAL OFFICE GUT &
LIVER
- Indexed
- SCIE; SCOPUS; KCI
- Document Type
- Review
- Abstract
- Background/AIms: Although acid suppressants are widely used for the prevention or treatment of drug-induced upper gastrointestinal bleeding (GIB), evidence regarding the prevention of anticoagulant-related GIB is scarce. The aim of this study was to evaluate the protective effect of acid suppressants against anticoagulant-related GIB. Methods: A systematic review was conducted of studies that evaluated the protective effect of acid suppressants against anticoagulant-related GIB found in PubMed, the Cochrane library, Embase, and KoreaMed from the date of database inception to April 2018. Random effect model meta-analyses with sensitivity analyses were conducted. The methodological quality of each included publication was evaluated using the Risk of Bias Assessment Tool for Nonrandomized Studies. Publication bias was assessed. Results: In total, six nested case-control or cohort studies were identified and analyzed. Proton-pump inhibitors (PPI) had a protective effect against upper GIB in patients on dicumarinics (risk ratio [RR], 0.56; 95% confidence interval [CI], 0.38 to 0.83; I-2, 0%); however, the histamine-2 receptor antagonist did not have the same effect (RR, 0.97; 95% CI, 0.52 to 1.81; I-2, 0%). Acid suppressants did not have a protective effect against GIB in patients on dabigatran (hazard ratio, 0.78; 95% CI, 0.44 to 1.37; I-2, 81.8%). Conclusions: The protective effect of PPIs against dicumarinics-related upper GIB was clear, while there was no evidence supporting the protective effect of acid suppressants against dabigatran-related GIB. However, in the absence of randomized trials demonstrating a lack of bias, solid conclusions cannot be drawn.
- DOI
- 10.5009/gnl19009
- Appears in Collections:
- 의과대학 > 의학과 > Journal papers
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