Effect of baseline characteristics on response to proton pump inhibitors in patients with peptic ulcer bleeding
Publication in refereed journal

香港中文大學研究人員
替代計量分析
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其它資訊
摘要OBJECTIVE

The rate of rebleeding from peptic ulcers could differ between Asian and Western populations. This study aimed to determine whether the observed twofold difference in rebleeding rates in two similarly designed clinical trials (one in Hong Kong [n = 240], the other in a predominantly Western population [n = 764, ClinicalTrials.gov identifier: NCT00251979]) can be explained by differences in baseline patient characteristics.

METHODS

Two-factor and multifactor analyses (adjusted by demographics, established risk factors for peptic ulcer and peptic ulcer bleeding, and disease severity variables) were performed using pooled data from the two studies. Cox regression analysis was used to predict the rebleeding risk at 3 days.

RESULTS

In the two-factor analysis (placebo vs esomeprazole/omeprazole and Western study vs Hong Kong study), data trended towards a reduced risk of rebleeding in the Western study (hazard ratio [HR] 0.69, 95% confidence interval [CI] 0.44–1.07, P = 0.094). The risk of rebleeding was similar in both studies after adjusted for multiple factors (HR 1.10, 95% CI 0.60–1.99, P = 0.767). The strongest predictor of rebleeding (apart from study drug) was a classification of American Society of Anesthesiologists (ASA) grade IV (HR 4.15, 95% CI 1.49–11.56, P = 0.006). When such patients were excluded, the difference in rebleeding rates between the studies reduced.

CONCLUSION

The difference in rebleeding rates between the two studies is explained by the factors in our analysis, most importantly a classification of ASA grade IV, suggesting that other differences, including ethnicity, did not influence the rebleeding rate.
著者James Lau, Tore Lind, Tore Persson, Stefan Eklund
期刊名稱Journal of Digestive Diseases
出版年份2017
月份2
卷號18
期次2
出版社Wiley
頁次99 - 106
國際標準期刊號1751-2972
語言英式英語

上次更新時間 2020-15-10 於 02:44