[Prevalence of rebleeding from peptic ulcer in patients treated with proton pump inhibitors].
OBJECTIVE
The aim of this study is to assess the prevalence of peptic ulcer rebleeding by comparing patients who received omeprazole versus pantoprazole i.v. as well as to study the costs of each treatment.


METHODS
Retrospective and observational study. Information was gathered on sex and age of the patients, the diagnosis of upper gastrointestinal bleeding (UGB) according to the classification of Forrest, the type of proton pump inhibitor (PPI) i.v. used and the treatment regimen, presence or absence of rebleeding, mortality and data on health costs through a pharmacoeconomic cost-effectiveness analysis.


RESULTS
We included 807 patients, 490 of whom (60.7%) received pantoprazole and 317 (39.3%) omeprazole. There was no difference between the average age of both groups, 61.2 years vs 62.3, p=0.544; sex, 71% men vs 68.6%, P=.78; the percentage of patients within Forrest I was 35.1% vs 42%, P=.05, in grade II was 50.2% vs 40.4%, P=.006 and in grade III was 14.7% vs 17.7%, P=.259. The number of vials per day of treatment was significantly lower in the pantoprazole group from the third to fifth day, with no differences in the first two days and the sixth. There was rebleeding in 8.2% of patients treated with pantoprazole and 11.7% with omeprazole, P=.098. 2.2% of patients treated with pantoprazole died vs 2.6% treated with omeprazole, P=.086. The expected cost of a patient treated with pantoprazole was 2188.25 euro vs 3279.02 euro with omeprazole, P<.001.


CONCLUSIONS
While the results of the administration of omeprazole vs pantoprazole i.v. in patients with UGB are similar, the latter turns out to have a better cost-effectiveness profile.
Garrido
Antonio
A
Servicio de Aparato Digestivo, Hospital Virgen del Rocío, Sevilla, España. agarser@telefonica.net
Iborra
María Isabel
MI
Saperas
Esteban
E
de Sousa
Mónica
M
D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000191:economics / Q000627:therapeutic use*; D000368:Aged; D016527:Drug Costs; D005260:Female; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data; D017721:Hospital Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000191:economics / Q000627:therapeutic use*; D000077402:Pantoprazole; D010437:Peptic Ulcer / Q000188:drug therapy* / Q000191:economics; D010438:Peptic Ulcer Hemorrhage / Q000191:economics / Q000453:epidemiology* / Q000517:prevention & control; D054328:Proton Pump Inhibitors / Q000191:economics / Q000627:therapeutic use*; D012008:Recurrence; D012189:Retrospective Studies; D012456:Salaries and Fringe Benefits; D012720:Severity of Illness Index; D016896:Treatment Outcome
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D054328:Proton Pump Inhibitors; D000077402:Pantoprazole; D009853:Omeprazole