Meta-analysis of the efficacy of proton pump inhibitors for the laryngopharyngeal reflux disease / 中国耳鼻咽喉头颈外科

ABSTRACT

OBJECTIVE To explore validity and reliability of proton pump inhibitors (PPI) in adult patients with laryngopharyngeal reflux disease(LPRD). METHODS Randomized and placebo-controlled clinical trials regarding the effectiveness of PPIs on LPRD patients were systematically extracted from PubMed, Cochrane Library, and EMBASE, Web of Science, CNKI, CBM, VIP and WANFANG from the beginning of indexing to August 2017. After selection and quality assessment, data were extracted from eligible studies meeting the exclusion and inclusion criteria. The Review Manager software(version 5.2, The Cochrane Collaboration) was performed for all of the statistical analysis in this meta-analysis. The level of evidence was assessed by the GRADE (Grades of Recommendation, Assessment, Development and Evaluation). RESULTS The sample comprised 14 RCTs including a pooled total of 821 LPRD patients were eligible for this meta-analysis, of which 447 and 374 patients took PPIs and placebo, respectively. Pooled results demonstrated that total RSI significantly improved for patients who received PPI therapy by comparing with those receiving placebo [SDM=2.12, 95％CI(0.80; 3.45), P<0.05]. PPI treatment group showed effective in response rate [OR=1.62, 95％CI (0.89, 2.95), P>0.05], but the differences between PPIs and placebo groups was not statistically significant. CONCLUSION PPI treatment could significantly improve reflux symptoms in LPRD patients, therefore, should be taken into consideration for LPRD management with other strategies, such as lifestyle modification.