Proton Pump Inhibitors updated on 08-09-2023

Preeclampsia

R analysis
id Study   Lib. in paper Exposition period    Study type 
 Control type 
 
Tags OR 95%CI x1/n1 x0/n0 no cases no exposed ROB Ref.
S14451
R57325		 Breddels, 2022 Pre-eclampsia (hypertension (systolic blood pressure>140 mmHg and/or diastolic blood pres- sure>90 mmHg) combined with proteinuria (24-h urine protein level>300 mg) 1st trimester population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes 0.91 [0.78;1.05] -/-   -/- - -
ref
S14449
R57314		 Van Gelder, 2022 Late-onset preeclampsia (new-onset hypertension accompanied by proteinuria after gestational week 34) 1st and 2nd trimester prospective cohort unexposed (general population or NOS) Adjustment: Yes 1.10 [0.50;2.60] 6/170   229/8,868 235 170
ref
S12491
R47111		 Choi (Controls exposed to other treatment, sick), 2021 All preeclampsia (exposure window during pregnancy) during pregnancy (anytime or not specified) population based cohort propective exposed to other treatment, sick excluded Adjustment: Yes 1.07 [0.96;1.20]
excluded (control group) 		350/25,484   3,770/331,795 4,120 25,484
ref
S12490
R47106		 Choi (Controls unexposed NOS), 2021 All preeclampsia (exposure window during pregnancy) during pregnancy (anytime or not specified) population based cohort propective unexposed (general population or NOS) Adjustment: Yes 1.26 [1.16;1.36] 638/43,717   18,040/1,920,243 18,678 43,717
ref
S4443
R10590		 Hastie, 2019 Preeclampsia (User Recorded 0–12 wk) 1st trimester population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes 1.11 [0.87;1.42] 75/1,371   -/- - 1,371
ref
S4444
R10512		 Cluver - Esomeprazole, 2018 Eclampsia late pregnancy randomized controlled trial unexposed, sick Adjustment: Randomisation 0.14 [0.01;2.73] C 0/59   3/60 3 59
ref
Total 5 studies 1.08 [0.87;1.34] 18,916 45,317
x1: number of endpoints among exposed, n1: number of exposed; x0: number of endpoints among non exposed, n0: number of non exposed; C: calculated odds ratio from numbers of events and effectives

Forest plot

StudyTE95% CIn casesn exposedweightROBABCDEF Breddels, 2022Breddels, 2022 0.91[0.78; 1.05]--32%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Van Gelder, 2022Van Gelder, 2022 1.10[0.50; 2.60]2351706%ROB confusion: seriousROB selection: unclearROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Choi (Controls unexposed NOS), 2021Choi, 2021 1 1.26[1.16; 1.36]18,67843,71736%ROB confusion: moderateROB selection: lowROB classification: moderateROB missing: unclearROB mesure: unclearROB reporting: moderate Hastie, 2019Hastie, 2019 1.11[0.87; 1.42]-1,37126%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Cluver - Esomeprazole, 2018Cluver - Esomeprazole, 2018 0.14[0.01; 2.73]3591%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Total (5 studies) I2 = 76% 1.08[0.87; 1.34]18,91645,3170.05.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed NOS;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.09[0.88; 1.35]18,91345,25879%NABreddels, 2022 Van Gelder, 2022 Choi (Controls unexposed NOS), 2021 Hastie, 2019 4 case control studiescase control studies 0 RCTRCT 0.14[0.01; 2.73]359 -NACluver - Esomeprazole, 2018 1 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.09[0.88; 1.35]18,91345,25879%NABreddels, 2022 Van Gelder, 2022 Choi (Controls unexposed NOS), 2021 Hastie, 2019 4 unexposed, sickunexposed, sick 0.14[0.01; 2.73]359 -NACluver - Esomeprazole, 2018 1 Tags Adjustment   - Randomisation  - Randomisation 0.14[0.01; 2.73]359 -NACluver - Esomeprazole, 2018 1   - Yes  - Yes 1.09[0.88; 1.35]18,91345,25879%NABreddels, 2022 Van Gelder, 2022 Choi (Controls unexposed NOS), 2021 Hastie, 2019 4 All studiesAll studies 1.08[0.87; 1.34]18,91645,31776%NABreddels, 2022 Van Gelder, 2022 Choi (Controls unexposed NOS), 2021 Hastie, 2019 Cluver - Esomeprazole, 2018 50.05.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-3.63.71.8280.000Breddels, 2022Van Gelder, 2022Choi (Controls unexposed NOS), 2021Hastie, 2019Cluver - Esomeprazole, 2018

Asymetry test p-value = 0.3439 (by Egger's regression)

slope=0.2385 (0.1018); intercept=-1.4886 (1.3278); t=1.1210; p=0.3439

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 12491

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.09[0.88; 1.35]18,97945,25879%NABreddels, 2022 Van Gelder, 2022 Choi (Controls unexposed NOS), 2021 Hastie, 2019 4 unexposed, sick controlsunexposed, sick controls Out of scale0.14[0.01; 2.73]359 -NACluver - Esomeprazole, 2018 1 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.07[0.96; 1.20]4,12025,484 -NAChoi (Controls exposed to other treatment, sick), 2021 10.510.01.0