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Editor's Correspondence |

High-Dose vs Non–High-Dose PPIs After Endoscopic Treatment in Patients With Bleeding Peptic Ulcer: Current Evidence Is Insufficient to Claim Equivalence

Xavier Calvet, MD, PhD; Alan Barkun, MD, MSc; Marc Bardou, MD, PhD; Joseph Sung, MD; Ernst J. Kuipers, MD
Arch Intern Med. 2010;170(18):1698-1699. doi:10.1001/archinternmed.2010.359.
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We read with interest the meta-analysis by Wang et al.1 The authors conclude that low-dose PPIs are as effective as high-dose PPI infusion to prevent recurrent peptic ulcer bleeding. In our opinion, there are strong methodological concerns about this study that could make its results and conclusions invalid. These concerns pertain both to the studies included in the analysis and to the methods used.

The study by Yilmaz et al,2 which included 211 of the total of 1157 patients in the meta-analysis, excluded patients with high-risk stigmata requiring endoscopic therapy. It should therefore not be included in the meta-analysis.

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