TITLE:
Efficacy and Safety of High-Dose Omeprazole Combined with Octreotide in the Treatment of Peptic Ulcer Bleeding: A Systematic Review and Meta-Analysis
AUTHORS:
Wan Li, Zixiong Zheng, Chuanxin Zou
KEYWORDS:
Omeprazole, Octreotide, Peptic Ulcer Hemorrhage, Randomized Controlled Trial, Meta-Analysis
JOURNAL NAME:
Journal of Biosciences and Medicines,
Vol.14 No.10,
October
26,
2026
ABSTRACT: Objective: To systematically evaluate the efficacy and safety of high-dose omeprazole combined with octreotide in treating bleeding peptic ulcers. Methods: A computerized search was conducted across China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), VIP, Wanfang Data, PubMed, Embase, The Cochrane Library, and Web of Science, up to September 1, 2026. Randomized controlled trials (RCTs) were included based on the PICOS principle. In the high-dose group, patients received octreotide combined with high-dose omeprazole (single dose of 50 - 120 mg administered via intravenous infusion or continuous infusion via micro-pump); in the standard-dose group, patients received octreotide combined with standard-dose omeprazole (single dose of 30 - 40 mg administered via intravenous infusion). Octreotide administration was identical between groups. Meta-analysis was performed using RevMan 5.4; odds ratios (OR) were used for dichotomous variables and mean differences (MD) for continuous variables, both reported with 95% confidence intervals (CI). Fixed- or random-effects models were selected according to heterogeneity, and funnel plots were used to assess publication bias. Results: The initial search yielded 190 relevant articles, which reduced to 122 after removing duplicates. After screening titles and abstracts according to inclusion and exclusion criteria, 30 articles remained. Full-text review confirmed the inclusion of 20 RCTs involving a total of 1800 patients. Subgroup analyses were conducted based on two predefined efficacy evaluation criteria: Standard 1 (based on 9 studies) showed that the high-dose group significantly outperformed the standard-dose group in terms of marked efficacy (OR = 2.77, 95% CI 2.08 - 3.70), inefficacy (OR = 0.17, 95% CI 0.10 - 0.28), and overall efficacy (OR = 5.83, 95% CI 3.55 - 9.56) (P 2 = 91%~100%) among these continuous outcomes limited the robustness of the findings. Publication bias assessment revealed funnel plots for dichotomous outcomes (including all efficacy measures and adverse events) were generally symmetrical, indicating low risk of bias. Funnel plots for the two continuous outcomes—hemostasis time and blood transfusion volume—showed asymmetric distributions, suggesting possible publication bias due to unpublished negative results or small-study effects. Conclusion: Current evidence indicates that high-dose omeprazole added to octreotide may improve hemostatic efficacy in peptic ulcer bleeding, shorten hemostasis time and hospital stay, reduce the need for blood transfusion, and does not significantly increase adverse events. However, most included studies were conducted in Chinese populations, with inadequate reporting of randomization, allocation concealment, and blinding; heterogeneity in intervention protocols; short follow-up periods; and lack of assessment of hard endpoints such as rebleeding, surgery, and mortality. Therefore, these findings require further validation through multicenter, large-scale, standardized randomized controlled trials (RCTs). This study has been registered with PROSPERO (CRD420261491716) and reported according to PRISMA guidelines.