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Meta‐analysis: the efficacy of over‐the‐counter gastro‐oesophageal reflux disease therapies
Author(s) -
TRAN T.,
LOWRY A. M.,
ELSERAG H. B.
Publication year - 2007
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.1365-2036.2006.03135.x
Subject(s) - medicine , jadad scale , placebo , antacid , gastroenterology , heartburn , randomized controlled trial , reflux , disease , pathology , alternative medicine , cochrane library
Summary Background Over‐the‐counter histamine‐2 receptor antagonists, antacids and alginate/antacids are commonly used for gastro‐oesophageal reflux disease. Aim To conduct a systematic review and meta‐analysis of related treatment trials. Methods We performed a systematic search and abstraction of randomized, placebo‐controlled trials conducted during 1972–2005. Study quality was measured by the Jadad score (0–5). Results were pooled using random effects model. Results Ten trials ( n = 3442, placebo = 2940; Jadad score 3.5) showed a higher response with histamine‐2 receptor antagonists in regard to complete relief of heartburn, symptomatic improvement, and episodes requiring rescue antacids. The absolute benefit increase was 10–12% and relative benefit increase was 19–41%. Four trials ( n = 578, placebo = 577; Jadad score 3.5) showed a trend in favour of antacids in symptomatic improvement (absolute benefit increase 8%, 95% CI: 0–16%; relative benefit increase 0.11) and requirement of rescue antacids (OR 0.70, 95% CI: 0.59–0.84). Four trials ( n = 146, placebo = 138; Jadad score 3.8) found alginate/antacid combination superior to placebo in symptomatic improvement (absolute benefit increase 26%, 95% CI: 12%–41%, relative benefit increase 0.60). Conclusions Over‐the‐counter medications are effective in treating symptomatic gastro‐oesophageal reflux disease. Compared with the placebo response, which ranged between 37% and 64%, the relative benefit increase was up to 41% with histamine‐2 receptor antagonists, 60% with alginate/antacid combinations, and 11% with antacids.