P.E.A.R.L.S: Inhibidores de la bomba de protones, mas efectivos en la esofagitis


Proton pump inhibitors (PPPIs)  most effective treatment for oesophagitis

 

Clinical Question

What is the most effective treatment for reflux oesophagitis?

Bottom Line

Proton pump inhibitor (PPI) therapy is the most effective treatment for short-term (8wks) management of gastro- oesophageal reflux disease (GORD)  – NNT= 1 to 2 (for PPI vs placebo). PPI better than H2 receptor antagonist (H2RA)  but both superior to placebo. There is a paucity of evidence on prokinectic therapy but no evidence that it is superior to placebo.

Context

GORD is a common problem with an estimated prevalence of 20% in adults. PPIs and H2RAs relieve symptoms by reducing acid secretion in the stomach.

Caveat

In equivalent dosage different PPI preparations do not show statistically significant differences in their healing effects. Although there was an apparently higher disease persistence rate at the end of the treatment with double dose PPI compared to standard dose, this difference was not statistically significant.

Reference

Mostafizur Khan, Jose Santana, Clare Donnellan, Cathryn Preston, Paul Moayyedi. Medical treatments in the short term management of reflux oesophagitis. Cochrane Database of Systematic Reviews 2007, Issue 2. Art. No.: CD003244. DOI: 10.1002/14651858.CD003244.pub2. This review contains 134 trials with 35978 participants.

Cochrane Reviews 2007, Issue 1.

Date (Author)  #19

May 2007 (Brian R McAvoy)

 

NNT = numbers needed to treat to benefit one person

NNH = numbers needed to harm to benefit one person

Both NNT and NNH are only reported if the studies or pooling of studies is statistically significant

Disclaimer : The P.E.A.R.L.S. are for educational use only and are not meant to guide clinical activity nor are they a clinical guideline.

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