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Meta-analysis: the efficacy of over-the-counter gastro-oesophageal reflux disease therapies
Article first published online: 16 OCT 2006
DOI: 10.1111/j.1365-2036.2006.03135.x
Additional Information
How to Cite
TRAN, T., LOWRY, A. M. and EL-SERAG, H. B. (2007), Meta-analysis: the efficacy of over-the-counter gastro-oesophageal reflux disease therapies. Alimentary Pharmacology & Therapeutics, 25: 143–153. doi: 10.1111/j.1365-2036.2006.03135.x
Publication History
- Issue published online: 16 OCT 2006
- Article first published online: 16 OCT 2006
- Publication data Submitted 27 June 2006 First decision 23 July 2006 Resubmitted 17 August 2006 Resubmitted 18 August 2006 Accepted 22 August 2006
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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.