Document Detail

Additional bedtime H2-receptor antagonist for the control of nocturnal gastric acid breakthrough.
MedLine Citation:
PMID:  19821323     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Nocturnal gastric acid breakthrough (NAB) is defined as intragastric pH<4 for more than one continuous hour overnight. Adding H(2)-receptor antagonists (H2RAs) at bedtime to high-dose proton pump inhibitors is likely to enhance nocturnal gastric pH control and decrease nocturnal gastric acid breakthrough.
OBJECTIVES: To assess the effectiveness of additional bedtime H2-receptor antagonists in suppressing nocturnal gastric acid breakthrough and the incidence of adverse effects.
SEARCH STRATEGY: We identified eligible trials by searching The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 4, 2008), MEDLINE (1966-August 2008), EMBASE (1980-August 2008) and CINAHL (1982-August 2008). We re-ran the search on CENTRAL (The Cochrane Library Issue 4, 2008), and in MEDLINE, EMBASE and CINAHL in June 2004, July 2005, August 2006 and August 2008.
SELECTION CRITERIA: All randomized controlled trials evaluating H2-receptor antagonists for the control of nocturnal gastric acid breakthrough were eligible for inclusion.
DATA COLLECTION AND ANALYSIS: Two reviewers have independently selected the trials to be included in the review according to the pre-stated eligibility criteria. Disagreements were resolved by a third reviewer. If the data could not be pooled for meta-analysis, a narrative description was provided.
MAIN RESULTS: 8 small randomized controlled trials were included for meta-analysis. The results show that additional bedtime H2RAs can decrease the prevalence rate of nocturnal gastric acid breakthrough. The results of the analyses for secondary outcomes show that additional bedtime H2RAs can decrease the percentage of time during which pH is less than 4.0 inside the stomach and promote median intragastric pH.
AUTHORS' CONCLUSIONS: We can conclude no implications for practice at this stage. Appropriately designed large-scale randomized controlled trials with long-term follow-up are needed to determine the effects of additional bedtime H2RAs in suppressing nocturnal gastric acid breakthrough.
Yiping Wang; Tao Pan; Qiong Wang; Zhen Guo
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Review     Date:  2009-10-07
Journal Detail:
Title:  The Cochrane database of systematic reviews     Volume:  -     ISSN:  1469-493X     ISO Abbreviation:  Cochrane Database Syst Rev     Publication Date:  2009  
Date Detail:
Created Date:  2009-10-12     Completed Date:  2010-01-27     Revised Date:  2013-06-28    
Medline Journal Info:
Nlm Unique ID:  100909747     Medline TA:  Cochrane Database Syst Rev     Country:  England    
Other Details:
Languages:  eng     Pagination:  CD004275     Citation Subset:  IM    
Department of Digestive Disease, Huaxi Hospital of Sichuan University, Guoxuexiang 37#, Chengdu, Sichuan Province, China, 610041.
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MeSH Terms
Drug Administration Schedule
Gastric Acid / secretion*
Histamine H2 Antagonists / administration & dosage*
Randomized Controlled Trials as Topic
Time Factors
Reg. No./Substance:
0/Histamine H2 Antagonists
Update Of:
Cochrane Database Syst Rev. 2004;(4):CD004275   [PMID:  15495095 ]

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