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Alginate therapy is effective treatment for gastroesophageal reflux disease symptoms: a systematic review and meta-analysis.

Publication ,  Journal Article
Leiman, DA; Riff, BP; Morgan, S; Metz, DC; Falk, GW; French, B; Umscheid, CA; Lewis, JD
Published in: Dis Esophagus
February 1, 2017

In patients with gastroesophageal reflux disease (GERD) and erosive esophagitis, treatment with proton pump inhibitors (PPIs) is highly effective. However, in some patients, especially those with non-erosive reflux disease or atypical GERD symptoms, acid suppressive therapy with PPIs is not as successful. Alginates are medications that work through an alternative mechanism by displacing the post-prandial gastric acid pocket. We performed a systematic review and meta-analysis to examine the benefit of alginate-containing compounds in the treatment of patients with symptoms of GERD.PubMed/MEDLINE, Embase and the Cochrane library electronic databases were searched through October 2015 for randomized controlled trials comparing alginate-containing compounds to placebo, antacids, histamine-2 receptor antagonists (H2RAs) or PPIs for the treatment of GERD symptoms. Additional studies were identified through bibliography review. Non-English studies and those with pediatric patients were excluded. Meta-analyses were performed using random-effects models to calculate odds ratios (OR). Heterogeneity between studies was estimated using the I2 statistic. Analyses were stratified by type of comparator. The search strategy yielded 665 studies and 15 (2.3%) met inclusion criteria. Fourteen were included in the meta-analysis (N = 2095 subjects). Alginate-based therapies increased the odds of resolution of GERD symptoms when compared to placebo or antacids (OR: 4.42; 95% CI 2.45-7.97) with a moderate degree of heterogeneity between studies (I2 = 71%, P = .001). Compared to PPIs or H2RAs, alginates appear less effective but the pooled estimate was not statistically significant (OR: 0.58; 95% CI 0.27-1.22). Alginates are more effective than placebo or antacids for treating GERD symptoms.

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Published In

Dis Esophagus

DOI

EISSN

1442-2050

Publication Date

February 1, 2017

Volume

30

Issue

2

Start / End Page

1 / 8

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Randomized Controlled Trials as Topic
  • Proton Pump Inhibitors
  • Middle Aged
  • Male
  • Humans
  • Histamine H2 Antagonists
  • Hexuronic Acids
  • Glucuronic Acid
  • Gastrointestinal Agents
 

Citation

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Leiman, D. A., Riff, B. P., Morgan, S., Metz, D. C., Falk, G. W., French, B., … Lewis, J. D. (2017). Alginate therapy is effective treatment for gastroesophageal reflux disease symptoms: a systematic review and meta-analysis. Dis Esophagus, 30(2), 1–8. https://doi.org/10.1111/dote.12535
Leiman, D. A., B. P. Riff, S. Morgan, D. C. Metz, G. W. Falk, B. French, C. A. Umscheid, and J. D. Lewis. “Alginate therapy is effective treatment for gastroesophageal reflux disease symptoms: a systematic review and meta-analysis.Dis Esophagus 30, no. 2 (February 1, 2017): 1–8. https://doi.org/10.1111/dote.12535.
Leiman DA, Riff BP, Morgan S, Metz DC, Falk GW, French B, et al. Alginate therapy is effective treatment for gastroesophageal reflux disease symptoms: a systematic review and meta-analysis. Dis Esophagus. 2017 Feb 1;30(2):1–8.
Leiman, D. A., et al. “Alginate therapy is effective treatment for gastroesophageal reflux disease symptoms: a systematic review and meta-analysis.Dis Esophagus, vol. 30, no. 2, Feb. 2017, pp. 1–8. Pubmed, doi:10.1111/dote.12535.
Leiman DA, Riff BP, Morgan S, Metz DC, Falk GW, French B, Umscheid CA, Lewis JD. Alginate therapy is effective treatment for gastroesophageal reflux disease symptoms: a systematic review and meta-analysis. Dis Esophagus. 2017 Feb 1;30(2):1–8.
Journal cover image

Published In

Dis Esophagus

DOI

EISSN

1442-2050

Publication Date

February 1, 2017

Volume

30

Issue

2

Start / End Page

1 / 8

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Randomized Controlled Trials as Topic
  • Proton Pump Inhibitors
  • Middle Aged
  • Male
  • Humans
  • Histamine H2 Antagonists
  • Hexuronic Acids
  • Glucuronic Acid
  • Gastrointestinal Agents