Pantoprazole and ranitidine in treatment of duodenal ulcer: a systematic review and pharmacoeconomics analysis / 中国药学杂志

ABSTRACT

OBJECTIVE: To systematically review the effectiveness and safety of pantoprazole in comparison with ranitidine for patients with duodenal ulcer, and evaluate the cost of the two drugs. METHODS: PubMed, Medline, EMbase, the Cochrane Library and three Chinese literature databases (VIP, CNKI and WanFang) were searched. Randomized controlled trials (RCTs) that compared the clinical outcomes of pantoprazole (PAN) group vs. ranitidine (RAN) group for duodenal ulcer were included. Two reviewers independently screened literature in accordance with the inclusion and exclusion criteria, extracted the data and assessed the methodological quality of included studies. Then, meta-analysis was performed using RevMan 5.2 software and cost-effectiveness analysis was performed with the decision tree model. RESULTS: A total of six RCTs involving 1 225 patients were included. The results of meta-analysis showed that PAN was superior to RAN in the 2-week or 4-week ulcers healing rates [RR = 1.61, 95% CI (1.44, 1.80), P<0.000 01 and RR = 1.18, 95% CI(1.12, 1.23), P <0.000 01, respectively]. Compared with RAN groups, PAN group had significantly higher rates of pain and gastrointestinal symptoms relief[RR = 1.31, 95% CI (1.15, 1.39); P<0.000 01 and RR = 1.18, 95% CI(1.08, 1.28), P = 0.000 3, respectively]. While there was no significant difference in the incidence of adverse events between the PAN and the RAN groups [RR = 1.35, 95% CI (0.87, 2.10), P = 0.19]. And the cost-effectiveness ratio was lower in the RAN group than in the PAN group (29.33 vs 53.90). CONCLUSION: Current evidence indicates that, pantoprazole is an effective scheme for duodenal ulcer, and ranitidine is considered as an economic choice. Both treatments are safe and well tolerated.