A Meta-analysis of PPIs Plus Alginate Versus PPIs Alone for the Treatment of GERD.

ABSTRACT

OBJECTIVE: To systematically evaluate the clinical efficacy and safety of proton-pump inhibitors (PPIs) combined with alginate versus PPIs alone in the treatment of gastroesophageal reflux disease (GERD). METHODS: Randomised Controlled Trials (RCTs) of PPIs combined with alginate and PPIs alone for the treatment of GERD in PubMed, Embase, and The Cochrane Library were searched and screened, and the risk assessment of bias and statistical analysis were performed using Rev Man 5.4 software. RESULTS: A total of four RCTs (608 patients) were included. Before and after treatment, the change of heartburn score in the experimental group increased compared with the control group, but the difference was not statistically significant [Standard Mean Difference (SMD)= -0.29, 95%CI (-0.78, 0.19), P > 0.05]; The change of HRDQ heartburn score increased, but the difference was not statistically significant [SMD= -0.40, 95%CI (-1.04, 0.24), P > 0.05]; The number of days without heartburn during the 28-day treatment period increased, but the difference was not statistically significant [OR= 1.16, 95%CI (0.37, 3.61), P > 0.05]; The amount of reflux score increased, but the difference was not statistically significant [SMD= -0.30, 95%CI (-0.71, 0.11), P > 0.05]; The amount of change in HRDQ regurgitation score increased, but the difference was not statistically significant [SMD= -0.05，95%CI （- 1.57，0.17）， P > 0.05]； There was no statistically significant difference in adverse events with treatment [OR= 0.93, 95%CI (0.58, 1.47), P > 0.05]. CONCLUSION: In the treatment of GERD, the efficacy of PPIs combined with alginate is improved compared with PPIs alone, but there is no significant difference, and alginate does not increase the occurrence of adverse events in PPIs treatment. In the future, more subdivisions of GERD subtypes and more high-quality studies are needed to further improve the treatment strategy of GERD-related diseases.