Сергей Александрович, я не против рекомендаций с гайдов, я интересуюсь: а какова сила их рекомендаций "Какие Ваши доказательства?" (С)
фамотидин лучше плацебы (лучше чем ничего):
At 12 weeks, comparing patients assigned to famotidine with patients assigned to placebo, gastric ulcers had developed in seven (3.4%) of 204 patients compared with 30 (15.0%) of 200 patients (odds ratio [OR] 0.20, 95% CI 0.09-0.47; p=0.0002); duodenal ulcers had developed in one (0.5%) patient compared with 17 (8.5%; OR 0.05, 0.01-0.40; p=0.0045); and erosive oesophagitis in nine (4.4%) compared with 38 (19.0%; OR 0.20, 0.09-0.42; p<0.0001), respectively.
Lancet. 2009 Jul 11;374(9684):119-25.
Famotidine for the prevention of peptic ulcers and oesophagitis in patients taking low-dose aspirin (FAMOUS): a phase III, randomised, double-blind, placebo-controlled trial.
Но в сравнении с празолами проигрывает:
Gastroenterology. 2009 Oct 15.
Famotidine is inferior to pantoprazole in preventing recurrence of aspirin-related peptic ulcers or erosions.
Ng FH, Wong SY, Lam KF, Chu WM, Chance P, Ling YH, Kng C, Yuen WC, Lau YK, Kwan A, Wong BC.
Department of Medicine and Geriatric, Ruttonjee Hospital, Hong Kong, China.
BACKGROUND & AIMS:: Little is known about the efficacy of H2 receptor antagonists in preventing recurrence of aspirin-related peptic ulcers. We compared the efficacy of high-dose famotidine with that of pantoprazole in preventing recurrent symptomatic ulcer/erosion. METHODS:: We performed a randomized, double-blind control trial of 160 patients with aspirin related peptic ulcers/erosions, with or without a history of bleeding. Patients were given either famotidine (40 mg, am and pm) or pantoprazole (20 mg am, placebo pm). All patients continued to receive aspirin (80 mg daily). The primary end-point was recurrent dyspeptic or bleeding ulcer/erosion within 48 weeks. RESULTS:: One hundred and thirty patients (81.1%) completed the study; 13/65 patients in the famotidine group reached the primary endpoint (20.0%; 95% one-sided confidence interval [CI] for the risk difference=0.1184, 1.0), compared with 0/65 patients in the pantoprazole group (P< 0.0001, 95% one-sided confidence interval [CI] for the risk difference=0.1184, 1.0).. Gastrointestinal bleeding was significantly more common in the famotidine group than the pantoprazole group (7.7% [5/65] vs 0% [0/65], 95% one-sided CI for the risk difference=0.0226, 1.0; P=0.0289); as was recurrent dyspepsia caused by ulcer/erosion (12.3% [8/65] vs 0% [0/65], 95% one-sided CI for the risk difference=0.0560, 1.0; P=0.0031). No patients had ulcer perforation or obstruction. CONCLUSIONS:: In patients with aspirin-related peptic ulcer/erosions, high-dose famotidine therapy is inferior to pantoprazole in preventing recurrent dyspeptic or bleeding ulcer/erosions.
Нужен трайл голова к голове, где фамотодин сравнят с празолом у пациентов на аспирине и клопидогреле и с ЖКТ проблемами и посмотрят перевесит ли эксцесс тромбоэпизодов эксцесс больших ЖКТ кровотечений...
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