Table 2 Results of a meta-analysis for the five gastroprotective strategies on primary and secondary health outcomes. Values are numbers of events (relative risks, with 95% confidence intervals) unless otherwise indicated
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|
H2 receptor antagonist v placebo
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Proton pump inhibitor v placebo
|
Misoprostol v placebo
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COX-2 selectives v non-selectives
|
COX-2 specifics v non-selectives
|
Primary outcomes
|
|
|
|
|
|
Total No of trial participants
|
2621
|
1358
|
16 945
|
28 178
|
25 564
|
Serious gastrointestinal complications
|
1 (0.33, 0.0 to 8.1)
|
3 (0.46, 0.1 to 2.9)
|
75 (0.57, 0.4 to 0.9)*
|
43 (0.61, 0.3 to 1.1)
|
114 (0.55, 0.4 to 0.8)
|
Symptomatic ulcers
|
1 (1.46, 0.1 to 35.5)
|
18 (0.09, 0.0 to 0.5)
|
54 (0.36, 0.2 to 0.7)*
|
82 (0.41, 0.3 to 0.7)*
|
281 (0.49, 0.4 to 0.6)*
|
Serious cardiovascular or renal events
|
5 (0.53, 0.1 to 3.5)
|
3 (0.78, 0.1 to 6.3)
|
4 (1.78, 0.3 to 12.1)
|
48 (0.95, 0.6 to 1.7)
|
241 (1.19, 0.8 to 1.8)
|
Mortality
|
1 (3.00, 0.1 to 68.3)
|
1 (0.17, 0.0 to 4.1)
|
35 (0.89, 0.5 to 1.7)
|
19 (0.68, 0.3 to 1.6)
|
78 (1.02, 0.6 to 1.9)
|
Health related quality of life
|
N/A
|
N/A
|
N/A
|
Weighted mean difference –0.10 (–1.0 to 0.8)
|
N/A
|
Secondary outcomes
|
|
|
|
|
|
Gastrointestinal symptoms
|
201 (0.72, 0.6 to 0.9)
|
45 (0.43, 0.2 to 0.8)*
|
1218 (0.97, 0.7 to 1.4)
|
3894 (0.73, 0.7 to 0.8)*
|
5184 (0.81, 0.7 to 0.9)*
|
Endoscopic ulcers
|
250 (0.55, 0.4 to 0.7)*
|
281 (0.37, 0.3 to 0.5)*
|
658 (0.33, 0.3 to 0.4)*
|
24 (0.41, 0.2 to 1.1)
|
522 (0.25, 0.2 to 0.3)*
|
Anaemia
|
1 (3.00, 0.1 to 73.3)
|
N/A
|
1 (2.66, 0.1 to 63.8)
|
6 (0.30, 0.1 to 1.3)
|
464 (0.62, 0.5 to 0.7)
|
Occult bleeding
|
N/A
|
N/A
|
16 (0.46, 0.2 to 1.3)
|
17 (0.86, 0.3 to 2.2)
|
N/A
|
Total dropouts
|
362 (0.97, 0.8 to 1.1)
|
116 (0.98, 0.6 to 1.5)
|
4772 (1.11, 1.0 to 1.2)
|
4274 (0.93, 0.9 to 1.0)*
|
9510 (0.82, 0.7 to 0.9)
|
Dropouts due to gastrointestinal symptoms
|
57 (0.71, 0.4 to 1.2)
|
48 (0.45, 0.3 to 0.8)*
|
2332 (1.36, 1.3 to 1.5)
|
1174 (0.63, 0.6 to 0.7)*
|
2171 (0.69, 0.6 to 0.8)
|
|
N/A=not available. Significance level 5%. *Significant protective relation, no heterogeneity and significance not lost on sensitivity analysis. Significant protective relationship, but significant heterogeneity or significance lost on sensitivity analysis. Significant harmful relationship, but significant heterogeneity or significance lost on sensitivity analysis. Significant harmful relationship, no heterogeneity and significance not lost on sensitivity analysis