The effectiveness and safety of histamine H2 receptor antagonists: An
umbrella review of meta-analyses
Abstract
Abstract Aim: To systematically assess the quality and credibility of
the correlations between H2RAs use with the risk of adverse outcomes.
Methods: In accordance with PRISMA, Meta-analyses of observational
studies and meta-analyses of randomized controlled trials (RCTs) were
included through searching 4 major databases from inception to 30 April
2022. AMSTAR 2 and GRADE were used to assess quality and certainty of
evidence. Results: Forty-six individual meta-analyses were identified,
including 30 meta-analyses of observation researches with 32 unique
outcomes and 19 meta-analyses of randomized controlled trails with 3
unique outcomes for comparing H2RAs versus non-H2RAs group. We confirmed
significant associations of H2RAs use with pneumonia (OR, 1.31; 95% CI,
1.04-1.64), peritonitis (OR, 2.16; 95% CI, 1.65-2.84), necrotizing
enterocolitis (OR, 1.80; 95% CI, 1.21-2.67), C difficile infection (OR,
1.25; 95% CI, 1.05-1.49), asthma(OR, 1.48; 95% CI 1.36-1.62), liver
cancer(OR, 1.41; 95% CI, 1.36-1.46), gastric cancer(OR, 1.41; 95% CI,
1.21-1.64) and hip fracture diseases(OR, 1.20; 95% CI, 1.13-1.27). No
associations for colorectal cancer, melanoma, kidney cancer, lung
cancer, common reproductive system cancer, renal, neurological, and
cardiovascular system diseases were observed. Conclusions: We found a
variety of evidence for the associations between H2RAs and adverse
outcomes, which would give clinicians more positive guidance on
prescription of H2RAs in clinical practice.