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On-Demand Therapy with Proton Pump Inhibitors for Maintenance Treatment of Nonerosive Reflux Disease or Mild Erosive Esophagitis: A Systematic Review and Meta-Analysis
المؤلفون المشاركون
Khan, Zubair
Khan, Mohammad Saud
Alastal, Yaseen
Khan, Muhammad Ali
Khalil, Basmah
Shrestha, Shreesh
Kamal, Faisal
Howden, Colin W.
Nawras, Ali T.
المصدر
Gastroenterology Research and Practice
العدد
المجلد 2018، العدد 2018 (31 ديسمبر/كانون الأول 2018)، ص ص. 1-10، 10ص.
الناشر
Hindawi Publishing Corporation
تاريخ النشر
2018-08-12
دولة النشر
مصر
عدد الصفحات
10
التخصصات الرئيسية
الملخص EN
Background.
Proton pump inhibitors (PPIs) are widely used for the long-term management of gastroesophageal reflux disease (GERD).
However, concerns about the cost and/or inconvenience of continuous maintenance PPI treatment have led to the evaluation of various alternative approaches.
Aim.
To assess the effectiveness of on-demand PPI therapy in the maintenance treatment of nonerosive reflux disease (NERD) or mild erosive esophagitis (EE).
Methods.
We searched MEDLINE, EMBASE, Web of Science, and Cochrane Library from inception until October 2, 2017, for randomized controlled trials (RCTs) comparing on-demand PPI versus placebo or daily PPI in the management of NERD or mild EE (Savary-Miller grade 1).
Discontinuation of therapy during the trial was used as a surrogate for patient dissatisfaction and failure of symptomatic control.
We calculated pooled odds ratios (OR) to evaluate the efficacy of on-demand PPI treatment.
Separate analyses were conducted for studies comparing on-demand PPI with daily PPI and with placebo.
Subgroup analysis was done based on NERD studies alone and on studies of both NERD and mild EE.
These were analyzed using a random effects model.
Results.
We included 10 RCTs with 4574 patients.
On-demand PPI was superior to daily PPI (pooled OR = 0.50; 95% confidence interval (CI) = 0.35, 0.72).
On subgroup analysis in NERD patients only, pooled OR was 0.44 (0.29, 0.66).
In studies including patients with NERD and mild EE, pooled OR was 0.76 (0.36, 1.60).
For studies comparing on-demand PPI with placebo, pooled OR was 0.21 (0.15, 0.29); subgroup analyses of studies evaluating NERD only and studies conducted in NERD and mild EE showed similar results (pooled OR was 0.22 (0.13, 0.36) and 0.18 (0.11, 0.31), resp.).
Conclusions.
On-demand PPI treatment is effective for many patients with NERD or mild EE.
Although not FDA-approved, it may be adequate for those patients whose symptoms are controlled to their satisfaction.
نمط استشهاد جمعية علماء النفس الأمريكية (APA)
Khan, Zubair& Alastal, Yaseen& Khan, Muhammad Ali& Khan, Mohammad Saud& Khalil, Basmah& Shrestha, Shreesh…[et al.]. 2018. On-Demand Therapy with Proton Pump Inhibitors for Maintenance Treatment of Nonerosive Reflux Disease or Mild Erosive Esophagitis: A Systematic Review and Meta-Analysis. Gastroenterology Research and Practice،Vol. 2018, no. 2018, pp.1-10.
https://search.emarefa.net/detail/BIM-1165281
نمط استشهاد الجمعية الأمريكية للغات الحديثة (MLA)
Khan, Zubair…[et al.]. On-Demand Therapy with Proton Pump Inhibitors for Maintenance Treatment of Nonerosive Reflux Disease or Mild Erosive Esophagitis: A Systematic Review and Meta-Analysis. Gastroenterology Research and Practice No. 2018 (2018), pp.1-10.
https://search.emarefa.net/detail/BIM-1165281
نمط استشهاد الجمعية الطبية الأمريكية (AMA)
Khan, Zubair& Alastal, Yaseen& Khan, Muhammad Ali& Khan, Mohammad Saud& Khalil, Basmah& Shrestha, Shreesh…[et al.]. On-Demand Therapy with Proton Pump Inhibitors for Maintenance Treatment of Nonerosive Reflux Disease or Mild Erosive Esophagitis: A Systematic Review and Meta-Analysis. Gastroenterology Research and Practice. 2018. Vol. 2018, no. 2018, pp.1-10.
https://search.emarefa.net/detail/BIM-1165281
نوع البيانات
مقالات
لغة النص
الإنجليزية
الملاحظات
Includes bibliographical references
رقم السجل
BIM-1165281
قاعدة معامل التأثير والاستشهادات المرجعية العربي "ارسيف Arcif"
أضخم قاعدة بيانات عربية للاستشهادات المرجعية للمجلات العلمية المحكمة الصادرة في العالم العربي
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