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Systematic review: proton pump inhibitors (PPIs) for the healing of reflux oesophagitis – a comparison of esomeprazole with other PPIs
Author(s) -
EDWARDS S. J.,
LIND T.,
LUNDELL L.
Publication year - 2006
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2006.03074.x
Subject(s) - esomeprazole , rabeprazole , omeprazole , lansoprazole , medicine , proton pump inhibitor , gastroenterology , pantoprazole , randomized controlled trial , meta analysis , reflux , reflux esophagitis , disease
Summary Background No randomized controlled trial has compared all the licensed standard dose proton pump inhibitors in the healing of reflux oesophagitis. Aim To compare the effectiveness of esomeprazole with licensed standard dose proton pump inhibitors for healing of reflux oesophagitis (i.e. lansoprazole 30 mg, omeprazole 20 mg, pantoprazole 40 mg and rabeprazole 20 mg). Methods Systematic review of CENTRAL, BIOSIS, EMBASE and MEDLINE for randomized controlled trials in patients with reflux oesophagitis. Searching was completed in February 2005. Data on endoscopic healing rates at 4 and 8 weeks were extracted and re‐analysed if not analysed by intention‐to‐treat. Meta‐analysis was conducted using a fixed effects model. Results Of 133 papers identified in the literature search, six were of sufficient quality to be included in the analysis. No studies were identified comparing rabeprazole with esomeprazole. A meta‐analysis of healing rates of esomeprazole 40 mg compared with standard dose proton pump inhibitors gave the following results: at 4 weeks [relative risk (RR) 0.92; 95% CI: 0.90, 0.94; P < 0.00001], and 8 weeks (RR 0.95; 95% CI: 0.94, 0.97; P < 0.00001). Publication bias did not have a significant impact on the results. The results were robust to changes in the inclusion/exclusion criteria and using a random effects model. Conclusion Esomeprazole consistently demonstrates higher healing rates when compared with standard dose proton pump inhibitors.