Efficacy of Proton-Pump Inhibitors in Children With Gastroesophageal Reflux Disease: A Systematic Review Full Text
Evidence Based Medicine
Van Der Pol RJ et al. - Proton-pump inhibitors (PPIs) are not effective in reducing gastroesophageal reflux disease (GERD) symptoms in infants. Placebo-controlled trials in older children are lacking. Although PPIs seem to be well tolerated during short-term use, evidence supporting the safety of PPIs is lacking.Methods
- The authors searched PubMed, Embase, and the Cochrane Database of Systematic Reviews for randomized controlled trials and crossover studies investigating efficacy and safety of PPIs in children aged 0 to 18 years with GERD for reduction in GERD symptoms, gastric pH, histologic aberrations, and reported adverse events.
- 12 studies were included with data from children aged 0–17 years.
- For infants, PPIs were more effective in 1 study (compared with hydrolyzed formula), not effective in 2 studies, and equally effective in 2 studies (compared with placebo) for the reduction of GERD symptoms.
- For children and adolescents, PPIs were equally effective (compared with alginates, ranitidine, or a different PPI dosage).
- For gastric acidity, in infants and children PPIs were more effective (compared with placebo, alginates, or ranitidine) in 4 studies.
- For reducing histologic aberrations, PPIs showed no difference (compared with ranitidine or alginates) in 3 studies.
- 6 studies reported no differences in treatment-related adverse events (compared with placebo or a different PPI dosage).