Short-term treatment of gastric ulcer

Gastric ulcer is relatively infrequent, and clinical trials are often based on small-sized samples. The aim of this study was to define the gold standard therapy of active gastric ulcer. We included all single- or double-blind clinical trials on the short-term treatment of gastric ulcer. All the articles published over the period 1977–1994 were reviewed. Meta-analysis was done with both fixed and random effect models; results were shown using Galbraith's radial plot. Forty-eight papers comprising 52 studies were evaluated. Cimetidine, ranitidine, and famotidine proved significantly better than placebo odds ratio (OR) and 95% confidence interval (CI 95%) at four to six weeks were: 2.67 (2.03–3.52), 3.94 (2.28–6.80), 1.76 (1.08–2.88), respectively]. Cimetidine and ranitidine had results comparable with the newer H₂ blockers OR (CI 95%) at four weeks: 1.16 (0.91–1.47), 1.11 (0.80–1.55), respectively]. H₂ blockers were proved comparable with either sucralfate OR (CI 95%) at eight weeks: 0.81 (0.37–1.79)] or bismuth OR (CI 95%) at four to six weeks: 0.67 (0.37–1.20)]. Omeprazole is more effective than H₂ blockers OR (CI 95%) at four weeks: 2.00 (1.57–2.55)]. It is concluded that H₂ blockers are preferred to either a placebo or sucralfate for short-term gastric ulcer treatment; the newer H₂ blockers do not have significant advantages over the older types; omeprazole can be regarded as the gold standard for active gastric ulcer treatment.The statistical analysis and computing with plot program was performed by G. Leandro, MD, Biostatistician. This work was performed under the auspices of the Roberto Farini Foundation for Gastroenterological Research.