Proton pump inhibitors forthe initialtreatment of gastroesophageal reflux disease (gord) symptoms in patientswith reflux oesophagitis: a systematic review of randomised controlled trials
Abstract
PGI2 PROTON PUMP INHIBITORS FORTHE INITIALTREATMENT OF GASTROESOPHAGEAL REFLUX DISEASE (GORD) SYMPTOMS IN PATIENTSWITH REFLUX OESOPHAGITIS: A SYSTEMATIC REVIEW OF RANDOMISED CONTROLLED TRIALS Edwards SJ, Borrill J AstraZeneca UK Ltd, Luton, UK OBJECTIVES: To compare the efficacy of esomeprazole with that of the European licensed standard doses of PPIs for the relief of GORD-associated symptoms in patients with reflux oesophagitis (i.e. esomeprazole 40 mg once-daily compared with lansoprazole 30 mg, omeprazole 20 mg, pantoprazole 40 mg, or rabeprazole 20 mg once-daily). METHODS: A systematic review of CENTRAL, BIOSIS, EMBASE and MEDLINE for randomised controlled trials (RCTs) in patients with erosive oesophagitis was conducted in January 2007. Data on relief of GORD symptoms at 4 weeks were extracted and re-analysed if not analysed by intention-to-treat. The summary effect estimate (relative risk [RR]) was calculated by meta-analysis using a fixed-effects model. Publication bias was assessed using funnel plots. RESULTS: Of 347 papers identified in the literature search, 11 were found to be head-to-head comparisons of a standard dose of PPI and esomeprazole 40 mg. Five RCTs were excluded as they did not contain any extractable data on the required outcomes at 4 weeks. The remaining 6 RCTs were all randomised, double-blind, double-dummy, had appropriate patient follow-up, and were of sufficient quality to be included. A meta-analysis of complete resolution of heartburn showed…
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