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Figure 1. Esophagitis Healing Rates at 4 and 8 Weeks: PPI Vs PPI (% Risk Difference)

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Figure 1. Esophagitis Healing Rates at 4 and 8 Weeks: PPI Vs PPI (% Risk Difference) Figure 1. Esophagitis healing rates at 4 and 8 weeks: PPI vs PPI (% risk difference) Healing rate difference at 4 weeks Esomeprazole 40mg vs Richter, 2001 Omeprazole 20mg Lansoprazole 15mg vs Castell, 1996 Omeprazole 20mg Castell, 1996 Lansoprazole 30mg vs Hatlebakk, 1993 Omeprazole 20mg Mee, 1996 Lansoprazole 30mg vs Mulder, 1996 Omeprazole 40mg Pantoprazole 40mg vs Corinaldesi, 1995 Omeprazole 20mg Pantoprazole 40mg vs Dupas, 2001 Lansoprazole 30mg Rabeprazole 10mg vs Delchier, 2000 Omeprazole 20mg Rabeprazole 20mg vs Delchier, 2000 Omeprazole 20mg -0.2 -0.1 0 0.1 0.2 Lansoprazole 30mg vs Omeprazole 20mg, 4 weeks Castell, 1996 Hatlebakk, 1993 Mee, 1996 -0.166 -0.091 -0.016 0 0.059 0.134 DL pooled risk difference = 0.011701 (95% CI = -0.030242 to 0.053643) Figure 1 (continued) Esophagitis Healing at 4 Weeks Study Risk difference (%) (95% CI) esomeprazole 40mg vs omeprazole 20mg once daily Richter, 2001 12.0 (8.5, 15.6) lansoprazole 15mg vs omeprazole 20mg once daily Castell, 1996 -7.6 (-14.6, -0.5) lansoprazole 30mg vs omeprazole 20mg once daily Castell, 1996 0.00 (-5.4, 5.4) Hatlebakk, 1993 -3.4(-15.9, 19.1) Mee, 1996 5.4 (-2.4, 13.2) Pooled risk difference = 1.17 (95% CI -3.02, 5.36) lansoprazole 30mg vs omeprazole 40mg once daily Mulder, 1996 6.8 (-3.4, 17.0) pantoprazole 40mg vs omeprazole 20mg Corinaldesi, 1995 -1.1 (-12.9, 10.7) pantoprazole 40mg vs lansoprazole 30mg Dupas, 2001 1.0% (-6.3, 8.2) rabeprazole 10mg vs omeprazole 20mg Delchier, 2000 -5.8 (-14.6, 2.9) rabeprazole 20mg vs omeprazole 20mg Delchier, 2000 -2.8 (-11.0, 5.4) Figure 1 (continued) Esophagitis healing rate difference at 8 weeks Esomeprazole 40mg vs Richter, 2001 Omeprazole 20mg Lansoprazole 15mg vs Castell, 1996 Omeprazole 20mg Castell, 1996 Lansoprazole 30mg vs Hatlebakk, 1993 Omeprazole 20mg Mee, 1996 Lansoprazole 30mg vs Mulder, 1996 Omeprazole 40mg Pantoprazole 40mg vs Omeprazole 20mg Corinaldesi, 1995 Pantoprazole 40mg vs Lansoprazole 30mg Dupas, 2001 Rabeprazole 10mg vs Omeprazole 20mg Delchier, 2000 Rabeprazole 20mg vs Delchier, 2000 Omeprazole 20mg -0.21 -0.11 -0.0 10 0.09 0.19 Lansoprazole 30mg vs Omeprazole 20mg, 8 weeks Castell, 1996 Hatlebakk, 1993 Mee, 1996 -0.20 -0.12 -0.04 0 0.04 0.12 DL pooled risk difference = 0.007622 (95% CI = -0.027688 to 0.042933) Figure 1 (continued) Esophagitis Healing at 8 Weeks Study Risk difference (%) (95% CI) esomeprazole 40mg vs omeprazole 20mg once daily Richter, 2001 9.0 (6.2, 11.8) lansoprazole 15mg vs omeprazole 20mg once daily Castell, 1996 -11.8(-18.3, -5.2) lansoprazole 30mg vs omeprazole 20mg once daily Castell, 1996 0.02 (-4.3, 4.7) Hatlebakk, 1993 -3.1(-12.7, 6.6) Mee, 1996 4.3 (-2.8, 11.3) Pooled risk difference = 0.76 (95% CI -0.02, 4.29) lansoprazole 30mg vs omeprazole 40mg once daily Mulder, 1996 2.9 (-4.4, 10.3) pantoprazole 40mg vs omeprazole 20mg Corinaldesi, 1995 1.5 (-8.6, 11.6) pantoprazole 40mg vs lansoprazole 30mg Dupas, 2001 3.9% (-2.1, 9.8) rabeprazole 10mg vs omeprazole 20mg Delchier, 2000 -2.9 (-10.0, 4.2) rabeprazole 20mg vs omeprazole 20mg Delchier, 2000 -3.8 (-11.0, 3.5) Figure 2. PPI vs. H2 Receptor antagonists for esophagitis healing at 8 weeks. 100% L 90% L O O R O O O O 80% L P L O P P O PPI % healing 70% O L 60% P L O 50% 20% 30% 40% 50% 60% 70% H2 % healing Estimated healing rate Mean 95% CrI Lansoprazole 78.8% 69.7% 86.4% Omeprazole 79.3% 72.2% 85.3% Pantoprazole 71.2% 59.0% 81.4% Rabeprozole 85.6% 67.9% 95.4% Difference between PPIs Mean difference 95% CrI Lansoprazole vs Omeprazole -0.5% -11.6% 10.0% Lansoprazole vs Pantoprazole 7.5% -5.9% 22.1% Lansoprazole vs Rabeprazole -6.9% -20.5% 12.2% Omeprazole vs Pantoprazole 8.1% -4.3% 21.7% Omeprazole vs Rabeprazole -6.4% -18.9% 12.2% Pantoprazole vs Rabeprazole -14.4% -30.4% 5.5% Figure 3. Duodenal Ulcer Healing at 4 weeks: PPI vs PPI (% risk difference) Ekstrom 1995 ((l30) vs (o20) Chang 1995 (l30) vs (o20) Lansoprazole 30mg vs Chang 1995 (l30) vs (o20) omeprazole 20mg Dobrilla 1999 (l30) vs (o20) Capruso 1995 (l30) vs (o20) Pantoprazole 40mg vs Beker 1995 (p40) vs (o20) omeprazole 20mg Rabeprazole 20mg vs Dekkers 1999 (r20) vs (o20) omeprazole 20mg Esomeprazole 40mg vs Tulassy 2001 (o40) vs (e40) omeprazole 40mg .20 -10 0% 10 20 Study Risk difference (%) (95% CI) Lansoprazole 30mg vs omeprazole 20mg once daily Ekstrom 1995 0.96 (-3.80, 6.15) Chang 1995 2.55 (-9.62, 15.5) Chang 1995 6.14 (-7.0, 20) Dobrilla 1999 -3.57 (-8.84, 3.14) Capruso 1995 -0.34 (-11.41, 10.32) Pooled risk difference = -0.2 (95% CI -3.0, 2.6) Pantoprazole 40mg vs omeprazole 20mg once daily Beker 1995 5.85 (-0.84, 12.95) Rabeprazole 20mg vs omeprazole 20mg once daily Dekkers 1999 4.84 (-0.96, 11.70) Esomeprazole 40mg vs omeprazole 40mg once daily Tullassay 2001 -0.97 (-6.4, 4.35) Figure 4. PPI vs. H2 Receptor antagonists for duodenal ulcer healing at 4 weeks 100% O O O P O L P O O O O OL OOP O 90% P L OO R PPI % healing O 80% L 70% 60% 70% 80% 90% H2 % healing Figure 4 (continued) Duodenal ulcer healing rate at 4 weeks Estimated healing rate when H2 healing is… Mean 95% CrI Lansoprazole 60% 73.3% 55.8% 86.9% 73% 89.6% 85.0% 93.5% 80% 93.9% 89.5% 97.1% 90% 97.0% 92.6% 99.3% Omeprazole 60% 82.6% 75.5% 88.7% 73% 90.9% 88.7% 93.1% 80% 93.7% 91.9% 95.4% 90% 96.3% 94.5% 97.8% Pantoprazole — 93.9% 90.9% 96.2% Rabeprozole — 82.6% 70.9% 91.1% Difference between PPIs when H2 healing is… Mean difference 95% CrI Lansoprazole vs Omeprazole 60% -9.3% -28.1% 6.1% 80% 0.2% -4.6% 3.8% 90% 0.8% -4.0% 3.8% Lansoprazole vs Pantoprazole 80% 0.0% -5.0% 4.4% Lansoprazole vs Rabeprazole 73% 7.0% -2.5% 19.3% Omeprazole vs Pantoprazole 80% -0.2% -3.1% 3.3% Omeprazole vs Rabeprazole 73% 8.3% -0.2% 20.3% Pantoprazole vs Rabeprazole — 11.3% 2.4% 23.2% Figure 5. Gastric Ulcer: PPI vs H2-Antagonist healing at 4 weeks (% risk difference) Omeprazole 40mg vs Cooperative Study 1990 (o40) vs (r) ranitidine 300mg Walan 1989 (o40) vs (r) Walan 1989 (o20) vs (r) Omeprazole 20mg vs Rossini 1989 (o20) vs (r) ranitidine 300mg Classen 1985 (o20) vs (r) Bardhan 1994 (l30) vs (r) Lansoprazole 30mg vs Michel 1994 (l30) vs (r) ranitidine 300mg Capurso1 995 (l30) vs (r) lansoprazole 60mg vs Bardhan 1994 (l60) vs (r) ranitidine 300mg Tsuji 1995 (l30) vs (f) lansoprazole 30mg vs famotidine 40mg Okai 1995 (l30) vs (f) Pantoprazole 40mg vs Hotz 1995 (p40) vs (r) ranitidine 300mg Omeprazole 20mg vs Bate 1989 (o20) vs (c800) cimetidine 800mg Aoyama 1995 (l30) vs (c800) Lansoprazole 30mg vs cimetidine 800mg Lauritsen 1988 (o30) vs (c1000) Omeprazole 30mg vs Danish Omeprazole Study Group 1989 (o30) vs (c1000 cimetidine 1000mg -30% -5%0% 20% 45% 70% 95% Study Risk difference (%) (95% CI) Cooperative Study 1990 (o40) vs(r) 22.92% (-7.50%, 47.83%) Walan 1989 (o40) vs (r) 21.02%(11.31%, 30.37%) Walan 1989 (o20) vs (r) 9.97% (-0.19%, 19.92%) Rossini 1989 (o20) vs (r) 22.22% (-22.28%, 59.36%) Classen 1985 (o20) vs (r) 1.09% (-10.66%, 12.83%) Bardhan 1994 (l30) vs (r) 17.82% (2.82%, 32.26%) Michel 1994 (l30) vs (r) 12.66% (-2.53%, 27.31%) Capurso1 995 (l30) vs (r) 2.43% (-12.18%, 16.35%) Bardhan 1994 (l60) vs (r) 23.22% (8.78%, 37.08%) Tsuji 1995 (l30) vs (f) 62.50% (12.85%, 87.18%) Okai 1995 (l30) vs (f) 40.00% (-4.08%, 71.22%) Hotz 1995 (p40) vs (r) 24.67% (12.15%, 37.01%) Bate 1989 (o20) vs (c800) 15.08% (1.45%, 28.38%) Aoyama 1995 (l30) vs (c800) 24.06% (-0.38%, 47.17%) Lauritsen 1988 (o30) vs (c1000) 8.56% (-4.24%,21.27%) Danish Omeprazole Study Group 1989 (o30) vs (c1000mg) 19.07% (3.49%, 33.82%) Figure 6. NSAID-induced Gastric Ulcer healing Rates at 8 weeks (% risk difference) Agrawal 2000 lansoprazole 15mg vs ranitidine ne di i t Agrawal 2000 lansoprazolle 30mg vs ranitidine rani o Yeomans 1998 omeprazole 20mg vs ranitidine pared t Com Yeomans 1998 omeprazole 40mg vs ranitidine Hawkey 1998 omeprazole 20mg vs misoprostol Hawkey 1998 omeprazole 40mg vs misoprostol -0.1 0 0.1 0.2 0.3 0.4 Table 2. Randomized controlled trials of GERD treatment: PPI vs PPI Number Screened, Esophagitis Grade Eligible, Enrolled, Author (Grading Criteria), Other Withdrawn, Lost to Healing Rate at Healing Rate at Year Population Setting Characteristics Followup 4 Weeks 8 Weeks Castell 1070 US patients at multiple Grade 2: 61%-71% 1284 enrolled, 1226 (l)15: 72.0% (l)15: 75.2% 1996 centers (number excludes Grade 3: 24%-30% analyzed (total with (l)30: 79.6% (l)30: 87.1% placebo), mean age 47, Grade 4: 6%-9% placebo) (o)20: 87.0% (o)20: 87.0% (range 18-84); 60-68.4% male; (See Appendix E for scale) (l)30 vs (l)15 (l)30 vs (l)15 85% white, 9% black, 5% 6.5%-8.7% Barrett's p<.05 p<.05 Hispanic.
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