SynthesisThe lancet. Gastroenterology & hepatology2018
Effects of gastroprotectant drugs for the prevention and treatment of peptic ulcer disease and its complications: a meta-analysis of randomised trials.
Synthesis in The lancet. Gastroenterology & hepatology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 96 papers, 7 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
96 citing papers in PubMed, 7 syntheses or guidelines pooled it, 245 citations in OpenAlex.
- Evidence-based clinical practice guidelines for peptic ulcer disease 2026.Journal of gastroenterology · 2026Guideline
- Proton pump inhibitors for the prevention of non-steroidal anti-inflammatory drug-induced ulcers and dyspepsia.The Cochrane database of systematic reviews · 2025Pooled it
- Efficacy and safety of vonoprazan versus proton pump inhibitors in the treatment of peptic ulcer disease: a systematic review and network meta-analysis for randomized controlled trails.Frontiers in nutrition · 2024Pooled it
- Association of Antisecretory Drugs with Upper Gastrointestinal Bleeding in Patients Using Oral Anticoagulants: A Systematic Review and Meta-Analysis.The American journal of medicine · 2022Pooled it
- Evidence-based clinical practice guidelines for peptic ulcer disease 2020.Journal of gastroenterology · 2021Guideline
- Pooled it
- Do proton pump inhibitors increase mortality? A systematic review and in-depth analysis of the evidence.Pharmacology research & perspectives · 2020Pooled it
- Trial
- Fixed dose combination of aspirin and pantoprazole: Results of a multicenter, comparative, randomized, double-blind, double dummy, phase III study in Indian patients.Indian heart journalTrial
- Current Clinical Treatments and Challenges for Cardiovascular Diseases: From Therapeutic Expansion to Individualized Care.Journal of clinical medicine · 2026Article
- Aspirin in Primary Prevention of CVD: A Pragmatic Outline and Advice for Treatment Personalization.Journal of clinical medicine · 2026Review
- Tegoprazan for the Prevention of Nonsteroidal Anti-Inflammatory Drug-Induced Peptic Ulcers: Ready to Challenge Proton Pump Inhibitors?Gut and liver · 2026Article
- Management of Peptic Ulcer Disease in Patients Taking Antithrombotic Agents.The Korean journal of helicobacter and upper gastrointestinal research · 2026Review
- [Cardiovascular diseases and heart failure in diabetes: diagnostics and management (Update 2026)].Wiener klinische Wochenschrift · 2026Review
- The role of rivaroxaban in the management of coronary artery disease: an overview of five landmark clinical trials.Naunyn-Schmiedeberg's archives of pharmacology · 2026Review
- Aspirin Eugenol Ester Alleviates Gastric Injury by Inhibiting Ferroptosis and Oxidative Stress.Antioxidants (Basel, Switzerland) · 2026Article
- LOw-Dose RAbeprazole Therapy for Reducing Gastrointestinal Events in Patients with High Bleeding Risk (LORA-HBR): A Prospective, Multicenter, Interventional Study.Journal of clinical medicine · 2026Article
- Article
- Myricetin alleviates indomethacin-induced gastric ulcers in rats via antioxidant, anti-inflammatory and antiapoptotic mechanisms.Inflammopharmacology · 2025Article
- The Use of Proton Pump Inhibitors Among Adults in Norway-A Nationwide Drug Utilization Study.Pharmacology research & perspectives · 2025Article
36 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
16 authors at 11 institutions in 6 countries.
Funding
Abstract
backgroundGastroprotectant drugs are used for the prevention and treatment of peptic ulcer disease and might reduce its associated complications, but reliable estimates of the effects of gastroprotectants in different clinical settings are scarce. We aimed to examine the effects of proton-pump inhibitors (PPIs), prostaglandin analogues, and histamine-2 receptor antagonists (H2RAs) in different clinical circumstances by doing meta-analyses of tabular data from all relevant unconfounded randomised trials of gastroprotectant drugs.
methodsWe searched MEDLINE and Embase from Jan 1, 1950, to Dec 31, 2015, to identify unconfounded, randomised trials of a gastroprotectant drug (defined as a PPI, prostaglandin analogue, or H2RA) versus control, or versus another gastroprotectant. Two independent researchers reviewed the search results and extracted the prespecified outcomes and key characteristics for each trial. We did meta-analyses of the effects of gastroprotectant drugs on ulcer development, bleeding, and mortality overall, according to the class of gastroprotectant, and according to the individual drug within a gastroprotectant class.
findingsWe identified comparisons of gastroprotectant versus control in 849 trials (142 485 participants): 580 prevention trials (110 626 participants), 233 healing trials (24 033 participants), and 36 trials for the treatment of acute upper gastrointestinal bleeding (7826 participants). Comparisons of one gastroprotectant drug versus another were available in 345 trials (64 905 participants), comprising 160 prevention trials (32 959 participants), 167 healing trials (28 306 participants), and 18 trials for treatment of acute upper gastrointestinal bleeding (3640 participants). The median number of patients in each trial was 78 (IQR 44·0-210·5) and the median duration was 1·4 months (0·9-2·8). In prevention trials, gastroprotectant drugs reduced development of endoscopic ulcers (odds ratio [OR] 0·27, 95% CI 0·25-0·29; p<0·0001), symptomatic ulcers (0·25, 0·22-0·29; p<0·0001), and upper gastrointestinal bleeding (0·40, 0·32-0·50; p<0·0001), but did not significantly reduce mortality (0·85, 0·69-1·04; p=0·11). Larger proportional reductions in upper gastrointestinal bleeding were observed for PPIs than for other gastroprotectant drugs (PPIs 0·21, 99% CI 0·12-0·36; prostaglandin analogues 0·63, 0·35-1·12; H2RAs 0·49, 0·30-0·80; p
interpretationGastroprotectants, in particular PPIs, reduce the risk of peptic ulcer disease and its complications and promote healing of peptic ulcers in a wide range of clinical circumstances. However, this meta-analysis might have overestimated the benefits owing to small study bias.
fundingUK Medical Research Council and the British Heart Foundation.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.