Acid suppression therapy and its association with spontaneous bacterial peritonitis incidence : A systemic review and meta-analysis
© 2019 The Japan Society of Hepatology..
AIM: It is well known that the use of proton pump inhibitor (PPI) is widespread in patients with liver cirrhosis. PPI counteracts H2 receptor inhibitor (H2 RA) with its strong acid suppression effect. However, there is always a concern that PPI use may increase spontaneous bacteria peritonitis (SBP) development in cirrhotic patients. We aimed to investigate the association between acid suppression therapy (i.e. PPI or H2 RA) and SBP through meta-analysis.
METHODS: We searched PubMed, Medline, Web of Science, Cochrane library, and Embase for relevant studies published up to April 2019. Pooled OR and 95% CI were calculated by a random-effects model. Funnel plots and Egger's tests were performed for the evaluation of publication bias. Non-parametric "trim-and-fill" tests were conducted for sensitivity analysis.
RESULTS: A total of 20 original articles including 9566 cirrhotic patients were analyzed. The overall meta-analysis highlighted that PPI use was associated with the risk of SBP (pooled OR 1.77, 95% CI 1.49-2.11). The conclusion was irrespective of study methods, whereas the result was inconsistent only in South America. However, the conclusion might not be stable enough and should be extrapolated with caution. Unlike PPI, we found H2 RA was not associated with SBP (pooled OR 1.06, 95% CI 0.75-1.48).
CONCLUSIONS: In conclusion, PPI use, but not H2 RA, will increase the incidence of SBP in cirrhotic patients. In addition, H2 RA might be beneficial for patients who require long-term acid suppression therapy.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:50 |
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| Enthalten in: |
Hepatology research : the official journal of the Japan Society of Hepatology - 50(2020), 2 vom: 02. Feb., Seite 233-245 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Lin, Lin [VerfasserIn] |
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| Links: |
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| Themen: |
H2 receptor inhibitor |
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| Anmerkungen: |
Date Revised 28.09.2020 published: Print-Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1111/hepr.13447 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM302724311 |
|---|
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| 100 | 1 | |a Lin, Lin |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Acid suppression therapy and its association with spontaneous bacterial peritonitis incidence |b A systemic review and meta-analysis |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
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| 500 | |a Date Revised 28.09.2020 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © 2019 The Japan Society of Hepatology. | ||
| 520 | |a AIM: It is well known that the use of proton pump inhibitor (PPI) is widespread in patients with liver cirrhosis. PPI counteracts H2 receptor inhibitor (H2 RA) with its strong acid suppression effect. However, there is always a concern that PPI use may increase spontaneous bacteria peritonitis (SBP) development in cirrhotic patients. We aimed to investigate the association between acid suppression therapy (i.e. PPI or H2 RA) and SBP through meta-analysis | ||
| 520 | |a METHODS: We searched PubMed, Medline, Web of Science, Cochrane library, and Embase for relevant studies published up to April 2019. Pooled OR and 95% CI were calculated by a random-effects model. Funnel plots and Egger's tests were performed for the evaluation of publication bias. Non-parametric "trim-and-fill" tests were conducted for sensitivity analysis | ||
| 520 | |a RESULTS: A total of 20 original articles including 9566 cirrhotic patients were analyzed. The overall meta-analysis highlighted that PPI use was associated with the risk of SBP (pooled OR 1.77, 95% CI 1.49-2.11). The conclusion was irrespective of study methods, whereas the result was inconsistent only in South America. However, the conclusion might not be stable enough and should be extrapolated with caution. Unlike PPI, we found H2 RA was not associated with SBP (pooled OR 1.06, 95% CI 0.75-1.48) | ||
| 520 | |a CONCLUSIONS: In conclusion, PPI use, but not H2 RA, will increase the incidence of SBP in cirrhotic patients. In addition, H2 RA might be beneficial for patients who require long-term acid suppression therapy | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a H2 receptor inhibitor | |
| 650 | 4 | |a meta-analysis | |
| 650 | 4 | |a proton pump inhibitor | |
| 650 | 4 | |a spontaneous bacteria peritonitis | |
| 700 | 1 | |a Hou, Lijun |e verfasserin |4 aut | |
| 700 | 1 | |a Deng, You |e verfasserin |4 aut | |
| 700 | 1 | |a Zhao, Tianming |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Bangmao |e verfasserin |4 aut | |
| 700 | 1 | |a Sun, Chao |e verfasserin |4 aut | |
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