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在日本溃疡患者中,质子泵抑制剂真的比法莫替丁更具优势吗?

Are proton pump inhibitors really superior to famotidine in Japanese ulcer patients?

作者信息

Haruma Ken, Kamada Tomoari, Manabe Noriaki, Kusunoki Hiroaki, Honda Keisuke, Inoue Kazuhiko, Shiotani Akiko

机构信息

Division of Gastroenterology, Department of Internal Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki-City, Okayama-Prefecture 701-0192, Japan.

出版信息

Hepatogastroenterology. 2009 Jul-Aug;56(93):1059-63.

Abstract

BACKGROUND/AIMS: The study aim was to evaluate the efficacy of famotidine in Japanese patients with peptic ulcers; it was analyzed the pooled data from previously conducted clinical trials in Japan.

METHODOLOGY

In the present study was performed a meta-analysis of controlled trials of famotidine and proton pump inhibitors executed between 1985 to 2005. The patients included in this study were Japanese adults (> or = 19 years old) diagnosed with gastrointestinal ulcers, treated for an on-label indication at doses approved in Japan, and whose treatment outcomes were clearly shown. It was searched the JMEDPlus database for relevant data. Data were synthesized and the results expressed as relative risk (RR).

RESULTS

Of the nine articles analyzed with a total of 1,771 patients, 879 received famotidine, and 892 received proton pump inhibitors. For duodenal ulcer and the hemostatic effect on the upper gastrointestinal tract, there were no significant differences between the two groups (p = 0.064, p = 0.066, respectively), although proton pump inhibitors showed a significantly greater efficacy compared to famotidine for gastric ulcers (RR: 0.86 [95% CI: 0.78-0.93], p < 0.001).

CONCLUSIONS

In Japanese patients, there were no significant differences for duodenal ulcer and hemostatic effect on the upper gastrointestinal tract between famotidine and proton pump inhibitors.

摘要

背景/目的:本研究旨在评估法莫替丁对日本消化性溃疡患者的疗效;对日本此前开展的临床试验汇总数据进行分析。

方法

本研究对1985年至2005年间开展的法莫替丁与质子泵抑制剂对照试验进行荟萃分析。本研究纳入的患者为日本成年人(≥19岁),诊断为胃肠道溃疡,按日本批准的剂量接受标签适应证治疗,且治疗结果明确显示。在JMEDPlus数据库中检索相关数据。对数据进行综合分析,结果以相对危险度(RR)表示。

结果

在分析的9篇文章共1771例患者中,879例接受法莫替丁治疗,892例接受质子泵抑制剂治疗。对于十二指肠溃疡及上消化道止血效果,两组间无显著差异(分别为p = 0.064,p = 0.066),尽管与法莫替丁相比,质子泵抑制剂对胃溃疡显示出显著更高的疗效(RR:0.86 [95% CI:0.78 - 0.93],p < 0.001)。

结论

在日本患者中,法莫替丁与质子泵抑制剂在十二指肠溃疡及上消化道止血效果方面无显著差异。

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