Prevalence of rebleeding from peptic ulcer in patients treated with proton pump inhibitors

Background and 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. Patients and 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 (sic) vs 3279.02 (sic) 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. (C) 2009 Elsevier Espana, S.L. All rights reserved.