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Evid Based Med 6:88 doi:10.1136/ebm.6.3.88
  • Therapeutics

Review: misoprostol, double dose H2 receptor antagonists, and proton pump inhibitors reduce GI ulcers in long term NSAID use

Occurrence of endoscopic ulcers in patients receiving misoprostol (miso), standard or double dose H2 receptor antagonist (st-H2RA or dd-H2RA), or proton pump inhibitor (PPI) treatments for ≥3 months compared with placebo (pl) during non-steroidal anti-inflammatory drug (NSAID) use*

Comparisons Ulcer Weighted event rates RRR (95% CI) NNT (CI)†
*Abbreviations defined in glossary; RRR, NNT, and CI calculated from data in article using a fixed effects model.
†Calculated for endoscopic, not clinical, outcomes.
Miso v pl Gastric 2.5% v 12.9% 75% (67 to 82) 10 (9 to 12)
Duodenal 2.6% v 6.1% 54% (34 to 69) 29 (20 to 53)
st-H2RA v pl Duodenal 11.5% v 25.9% 64% (26 to 82) 29 (17 to 84)
dd-H2RA v pl Gastric 2.0% v 5.5% 56% (26 to 74) 7 (5 to 17)
Duodenal 3.4% v 13.6% 74% (35 to 89) 10 (7 to 25)
PPI v pl Gastric 6.6% v 19.6% 61% (45 to 73) 8 (6 to 13)
Duodenal 1.7% v 10.3% 81% (60 to 91) 12 (9 to 20)

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