SEARCHSYSTEMATIC_REVIEWgastroenterology, internal medicine

systematic_review·gastroenterology, internal medicine, systematic review·PMC10538946

Comparing the Safety and Efficacy of Proton Pump Inhibitors and Histamine-2 Receptor Antagonists in the Management of Patients With Peptic Ulcer Disease: A Systematic Review

Cureus · 10 authors, 3 centres

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TL;DR

This systematic review compared proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2RAs) for treating peptic ulcer disease.

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The review also notes common adverse effects for both drug classes, such as gastrointestinal symptoms, and highlights the need for calcium supplementation with long-term PPI use due to fracture risk in older adults. Implications suggest PPIs remain a primary treatment but require cautious prescription considering patient comorbidities, and future research should compare them with newer acid-suppressing drugs.

STUDY TYPE

systematic_review

SPECIALTY

gastroenterology

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AI pipeline

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100% · A

ORIGINAL PAPER

PMC10538946

Comparing the Safety and Efficacy of Proton Pump Inhibitors and Histamine-2 Receptor Antagonists in the Management of Patients With Peptic Ulcer Disease: A Systematic Review

Cureus

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ABSTRACT

Peptic ulcer disease (PUD) refers to the occurrence of an open erosion in the inner lining of the stomach, duodenum, or sometimes lower esophagus. Treatments like proton pump inhibitors (PPIs) or histamine 2 receptor antagonists (H2RAs) are available on the market to efficiently treat the break in the mucosal lining. However, there is little evidence about the effects of the medication on the type and location of the ulcer and the epigastric pain caused by disintegration and increased acidity in the stomach. Given the above, we conducted a systematic review comparing the safety and efficacy of PPIs and H2RAs in various ulcer locations (gastric, duodenal, and pre-pyloric) and the effect of prolonging the treatment with the same medication or changing into a drug from another class in treatment-resistant ulcers. We employed major research literature databases and search engines such as PubMed, Medical Literature Analysis and Retrieval System Online (MEDLINE), Science Direct, and Google Scholar to find relevant articles. After a thorough screening, a quality check using various tools, and applying filters that suited our eligibility criteria, we identified eight articles, of which five were random clinical trials (RCTs), two review articles, and one meta-analysis. This study compares the different side effects of PPIs and H2RAs. Most studies concluded that omeprazole is superior in healing ulcers and bringing pain relief and that patients resistant to H2RAs can be treated better when switched to a PPI. This study also discusses the adverse effects of chronic use, such as diarrhea, constipation, headaches, and gastrointestinal infections. Patients on long-term PPI therapy are required to take calcium supplements to prevent the risk of fractures in older adults. Regarding long-term outcomes, PPIs remain the mainstay of treatment for peptic ulcer disease, based on the papers we reviewed.

CITATION EXPORT

Maha Begg, Mawada Tarhuni, Monique N. Fotso et al.. Comparing the Safety and Efficacy of Proton Pump Inhibitors and Histamine-2 Receptor Antagonists in the Management of Patients With Peptic Ulcer Disease: A Systematic Review. Cureus. (2023). https://doi.org/10.7759/cureus.44341

AUTHORS

10 · 3 CENTRES

Maha Begg, Mawada Tarhuni, Monique N. Fotso, Natalie A Gonzalez, Raghavendra R Sanivarapu, Usama Osman, Abishek Latha Kumar, Aishwarya Sadagopan, Anas Mahmoud, Safeera Khan

1 Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
2 Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfiled, USA
3 Internal Medicine, Pediatrics, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA

EDITOR / REVIEWER

Alexander Muacevic, John R Adler