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Meta‐analysis: the efficacy of proton pump inhibitors for laryngeal symptoms attributed to gastro‐oesophageal reflux disease
Author(s) -
GATTA L.,
VAIRA D.,
SORRENTI G.,
ZUCCHINI S.,
SAMA C.,
VAKIL N.
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.1365-2036.2006.03213.x
Subject(s) - medicine , proton pump inhibitor , reflux , meta analysis , placebo , jadad scale , relative risk , gastro , disease , randomized controlled trial , confidence interval , gastroenterology , surgery , cochrane library , pathology , alternative medicine
Summary Background Many investigators have proposed an association between gastro‐oesophageal reflux disease and laryngo‐pharyngeal symptoms, suggesting that medical or surgical therapy for reflux may be useful. Aim To perform a meta‐analysis assessing the effectiveness of medical or surgical therapy for reflux disease in adult patients with laryngeal or pharyngeal symptoms presumed to be due to gastro‐oesophageal reflux disease. Methods Randomized controlled trials comparing medical or surgical treatments for gastro‐oesophageal reflux disease against placebo were identified by searching MEDLINE (1966–September 2005), EMBASE (1974–September 2005), the CCRCT (until September 2005) and abstracts from gastroenterology and ENT meetings. The relative risks of reporting symptomatic improvement or resolution of symptoms was evaluated using a random‐effects model. Results Five studies using high‐dose proton pump inhibitor as intervention met the inclusion criteria and were included in the meta‐analysis. No surgical studies met inclusion criteria. The pooled relative risk was 1.18 (95% confidence interval: 0.81–1.74). There was no heterogeneity between studies but evidence of significant publication bias. Sub‐group analysis performed evaluating Jadad scores and symptom type, did not change the relative risk. Conclusions Therapy with a high‐dose proton pump inhibitor is no more effective than placebo in producing symptomatic improvement or resolution of laryngo‐pharyngeal symptoms. Further studies are necessary to identify the characteristics of patients that may respond to proton pump inhibitor therapy.