Evidence map›Paper›PMID 33988530›Full record

SynthesisClinical and translational gastroenterology2021

Oral Proton Pump Inhibitors May Be as Effective as Intravenous in Peptic Ulcer Bleeding: A Systematic Review and Meta-analysis.

Endre Csiki, Hanna Szabó, Lilla Hanák, Zsolt Szakács, Szabolcs Kiss, Nóra Vörhendi, Dániel Pécsi, Eszter Hegyi, Péter Hegyi, Bálint Erőss

Open access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Clinical and translational gastroenterology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
3.5field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it, 27 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Acid peptic disorder compass: An Indian expert consensus on comprehensive management.World journal of gastrointestinal pharmacology and therapeutics · 2026
    Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 2 countries.

Endre CsikiInstitute for Translational Medicine, Medical School, Szentágothai Research Center, University of Pécs, Pécs, Hungary.
Hanna SzabóInstitute for Translational Medicine, Medical School, Szentágothai Research Center, University of Pécs, Pécs, Hungary.
Lilla HanákInstitute for Translational Medicine, Medical School, Szentágothai Research Center, University of Pécs, Pécs, Hungary.
Zsolt SzakácsInstitute for Translational Medicine, Medical School, Szentágothai Research Center, University of Pécs, Pécs, Hungary.
Szabolcs KissInstitute for Translational Medicine, Medical School, Szentágothai Research Center, University of Pécs, Pécs, Hungary.
Nóra VörhendiInstitute for Translational Medicine, Medical School, Szentágothai Research Center, University of Pécs, Pécs, Hungary.
Dániel PécsiDivision of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary .
Eszter HegyiInstitute for Translational Medicine, Medical School, Szentágothai Research Center, University of Pécs, Pécs, Hungary.
Péter HegyiInstitute for Translational Medicine, Medical School, Szentágothai Research Center, University of Pécs, Pécs, Hungary.
Bálint ErőssInstitute for Translational Medicine, Medical School, Szentágothai Research Center, University of Pécs, Pécs, Hungary.
University of Pecs · HUUniversitatea de Medicină, Farmacie, Științe și Tehnologie „George Emil Palade” din Târgu Mureș · RO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionCurrent guidelines recommend intravenous (IV) proton pump inhibitor (PPI) therapy in peptic ulcer bleeding (PUB). We aimed to compare the efficacy of oral and IV administration of PPIs in PUB.

methodsWe performed a systematic search in 4 databases for randomized controlled trials, which compared the outcomes of oral PPI therapy with IV PPI therapy for PUB. The primary outcomes were 30-day recurrent bleeding and 30-day mortality. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for dichotomous outcomes, while weighted mean differences (WMDs) with CI were calculated for continuous outcomes in meta-analysis. The protocol was registered a priori onto PROSPERO (CRD42020155852).

resultsA total of 14 randomized controlled trials reported 1,951 peptic ulcer patients, 977 and 974 of which were in the control and intervention groups, respectively. There were no statistically significant differences between oral and IV administration regarding 30-day rebleeding rate (OR = 0.96, CI: 0.65-1.44); 30-day mortality (OR = 0.70, CI: 0.35-1.40); length of hospital stay (WMD = -0.25, CI: -0.93 to -0.42); transfusion requirements (WMD = -0.09, CI: -0.07 to 0.24); need for surgery (OR = 0.91, CI: 0.40-2.07); further endoscopic therapy (OR = 1.04, CI: 0.56-1.93); and need for re-endoscopy (OR = 0.81, CI: 0.52-1.28). Heterogeneity was negligible in all analysis, except for the analysis on the length of hospitalization (I2 = 82.3%, P = 0.001). DISCUSSION: Recent evidence suggests that the oral administration of PPI is not inferior to the IV PPI treatment in PUB after endoscopic management, but further studies are warranted.

Indexed as

Administration, IntravenousAdministration, OralBlood TransfusionEndoscopy, GastrointestinalEquivalence Trials as TopicHumansLength of StayPeptic Ulcer HemorrhageProton Pump InhibitorsSecondary PreventionTreatment OutcomeProton Pump Inhibitors

Identifiers

PMID33988530
PMCPMC8049165
OpenAlexW3158437221

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.