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To evaluate whether proton pump inhibitors are more effective than H₂‐antagonists (H₂‐A) for the treatment of bleeding peptic ulcer.

PubMed database until January 2000.

Comparative randomized trials of proton pump inhibitors (omeprazole, lansoprazole, or pantoprazole) vs. H₂‐A (cimetidine, ranitidine or famotidine).

Meta‐analysis combining the odds ratios (OR) of the individual studies in a global OR (Peto method).

Persistent or recurrent bleeding, need for surgery, or mortality.

Eleven studies fulfilled the inclusion criteria and contained data for at least one of the planned comparisons. Persistent or recurrent bleeding was reported in 6.7% (95% CI: 4.9–8.6%) of the patients treated with proton pump inhibitors, and in 13.4% (95% CI: 10.8–16%) of those treated with H₂‐A (OR 0.4; 95% CI: 0.27–0.59) (χ² …