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Evidence summaries

Medical Treatments for Reflux Oesophagitis

Proton pump inhibitors (PPIs) are effective in oesophagitis but H2 receptors antagonist (H2RA) therapy is also superior to placebo. Level of evidence: "A"

A Cochrane review [Abstract] 1 [withdrawn from publication] included 134 studies with a total of 35,978 subjects. Five RCTs evaluated standard dose of PPI versus placebo in 965 participants. There was a statistically significant benefit of taking standard dose PPI therapy compared to placebo in healing of oesophagitis (RR = 0.22; 95% CI 0.15 to 0.31). Ten RCTs reported on the outcome for H2RA versus placebo evaluating 1241 participants. There was statistically significant benefit of taking H2RA compared to placebo in healing of oesophagitis (RR 0.74,95% CI = 0.66 to 0.84). Three RCTs evaluated prokinetic therapy versus placebo in 198 participants. There was no statistically significant benefit of taking prokinetic therapy compared to placebo in healing of oesophagitis (RR 0.71, 95% CI 0.46 to 1.10). Twenty six RCTs reported the outcome for PPI versus H2RA or H2RA plus prokinetics, evaluating 4032 participants. There was statistically significant benefit of taking PPI therapy compared to H2RA or H2RA plus prokinetics in healing of oesophagitis (RR 0.51, 95% CI 0.44 to 0.59).

References

  • Moayyedi P, Santana J, Khan M et al. WITHDRAWN: Medical treatments in the short term management of reflux oesophagitis. Cochrane Database Syst Rev 2011;(2):CD003244. [PubMed]

Primary/Secondary Keywords