| Title | Systematic review: standard- and double-dose proton pump inhibitors (PPIs) for the healing of severe erosive oesophagitis - a mixed treatment comparison of randomised controlled trials. | | Author(s) | Edwards SJ, Lind T, Lundell L, DAS R | | Institution | Outcomes Research, AstraZeneca UK Ltd, Luton, UK. | | Source | Aliment Pharmacol Ther 2009 Jun 25. | | Abstract | Background No randomised controlled trial (RCT) has compared all European-licensed standard- and double-dose PPIs for the healing of severe erosive oesophagitis. Aim To compare the effectiveness of licensed doses of PPIs for healing severe erosive oesophagitis (i.e. esomeprazole 40mg, lansoprazole 30mg, omeprazole 20mg and 40mg, pantoprazole 40mg and rabeprazole 20mg). Methods Systematic review of CENTRAL, EMBASE and MEDLINE for RCTs in patients with erosive oesophagitis (completed October 2008). Endoscopically-verified healing rates at 4 and 8 weeks were extracted and re-calculated if not analysed by intention-to-treat. Mixed treatment comparison was used to combine direct treatment comparisons with indirect trial evidence while maintaining randomisation. Odds ratios (OR) are reported compared to omeprazole 20mg. Results 3,021 papers were identified in the literature search; 12 were of sufficient quality to be included in the analysis. Insufficient data was available to included rabeprazole in the analysis. Esomeprazole 40mg was found to provide significantly higher healing rates at 4 weeks (OR 1.84, 95% Credible Interval [95%CrI]: 1.50 to 2.22) and 8 weeks (OR 1.91, 95% CrI: 1.13 to 2.88). No other PPI investigated had significantly higher healing rates than omeprazole 20mg. Conclusion Esomeprazole 40mg consistently demonstrates higher healing rates compared to licensed standard- and double-dose PPIs. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 19558609 |
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