Year | Source | N of included studies/patients | Regimen | 3-day rebleeding risk | 7-day rebleeding risk | Mortality |
2010 | Wang CH et al. High-dose vs. non-high-dose proton pump inhibitors after endoscopic treatment in patients with bleeding peptic ulcer: a systematic review and meta-analysis of randomized controlled trials [11] . | 7 RCT including 1157 patients | 80-mg bolus, followed by 8-mg/h continuous infusion for 72 hours. Continuous infusion doses exceeding 192 mg/d were also considered high-dose PPIs. Other doses were considered non-high-dose PPIs. | High-dose PPIs and non-high-dose PPIs did not differ in their effects on the rates of rebleeding OR, 1.30; 95% CI, 0.88 - 1.91. | No difference in mortality, OR 0.89; 95% CI 0.37 - 2.13. | |
2010 | Wu LC et al. High-dose vs. low-dose proton pump inhibitors for upper gastrointestinal bleeding: a meta-analysis. World J Gastroenterol [12] . | 9 RCTs, including 1342 patients, were included in the analysis. | The dosage of PPI was considered a high dose if at least twice the low dose of any PPIs was used during the 72 hours following endoscopic hemostasis. | A high-dose PPI regimen is not superior to a low-dose PPI regimen. | A high-dose PPI regimen is not superior to a low-dose PPI regimen. | |
2013 | Neumann I et al. Comparison of different regimens of proton pump inhibitors for acute peptic ulcer bleeding. Cochrane Database Syst Rev [14] . | 13 RCTs (1716 patients) | “High” dose regimens are considered 72-hour cumulative doses > 600 mg of intravenous PPI compared to other doses. | Insufficient evidence for concluding results | insufficient evidence for concluding results | |
2014 | Sachar H et al. Intermittent vs. continuous proton pump inhibitor therapy for high-risk bleeding ulcers: a systematic review and meta-analysis [15] . | 13 studies included in meta-analysis | 80-mg intravenous bolus followed by a continuous 8-mg/h intravenous infusion for 72 hours vs boluses (they could be once daily or more often; oral vs intravenous). | Intermittent PPI regimen is comparable to bolus plus continuous infusions RR < 1 | RR for intermittent vs. bolus plus continuous infusion of PPIs was 0.72 | RR for mortality < 1 |
2018 | Sgourakis G et al. A meta-analysis and meta-regression analysis. Turk J Gastroenterol [16] . | 10 RCTs included 1.651 patients. | A high-dose PPI regimen is identified as an 80 mg bolus followed by intravenous administration of 8 mg/h for 72 h; a low-dose regimen is not specified. | Significantly fewer cases of rebleeding in the low-dose PPI treatment arm | comparable outcomes. |