The efficacy of proton pump inhibitors in adults with functional dyspepsia

Shiau J Y, Shukla V K, Dube C
Record ID 32002000019
English, French
Authors' objectives:

Primary objective: To determine the efficacy of PPIs in the reduction of symptoms in adults with functional dyspepsia compared with placebo, prokinetic agents and H2-antagonists.

Secondary objectives: - to determine if the effect of PPIs differs between symptom subgroups (dysmotility-like, or ulcer-like) in functional dyspepsia; - to determine the safety of PPIs in functional dyspepsia; and - to determine if the effect of PPIs differs in H.pylori positive patients with functional dyspepsia

Authors' results and conclusions: PPIs are effective agents in reducing functional dyspepsia compared with placebo. For the combined good and excellent outcomes, an OR of 1.53 (95% CI 1.29-1.81) yields a number needed to treat (NNT) to improve one case of functional dyspepsia of 10; 95% CI 6.67- 16.67. Cautious comparison with other meta-analyses of treatment agents used in functional dyspepsia can be made. Cisapride, a prokinetic agent, compared with placebo for combined good and excellent outcomes [OR 4.25; 95% CI 3.42-5.27], has a NNT of 3.12, 95% CI 2.7- 3.57 . H2-antagonists are also effective compared with placebo for combined good and excellent outcomes [OR 2; 95% CI 1.16-3.45] with a NNT of 5.9; 95% CI 4.5-9.1.
Authors' recommendations: This meta-analysis demonstrates that PPIs are effective in functional dyspepsia as compared with placebo. Based on other meta-analyses, prokinetic agents such as cisapride and H2-antagonists have lower NNTs than PPIs and thus might appear more efficacious. Unfortunately, there are no direct comparison trials between the three agents and therefore there is no conclusive evidence that one agent is the best. Only one trial has demonstrated no difference between PPIs and H2-antagonists. Further RCTs comparing PPIs, other prokinetic agents (such as domperidone), and H2-antagonists, in H.pylori positive and negative patients with functional dyspepsia, are needed.
Authors' methods: Meta-analysis
Details
Project Status: Completed
URL for project: https://www.ccohta.ca/
Year Published: 2002
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Canada
MeSH Terms
  • Adult
  • Dyspepsia
  • Proton Pumps
Contact
Organisation Name: Canadian Coordinating Office for Health Technology Assessment
Contact Address: 600-865 Carling Avenue, Ottawa, ON K1S 5S8 Canada. Tel: +1 613 226 2553, Fax: +1 613 226 5392;
Contact Name: requests@cadth.ca
Contact Email: requests@cadth.ca
Copyright: Canadian Coordinating Office for Health Technology Assessment (CCOHTA)
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