Document Detail


Cisapride treatment for gastro-oesophageal reflux in children: a systematic review of randomized controlled trials.
MedLine Citation:
PMID:  11115025     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The aim of the systematic review was to determine the effect of cisapride compared with placebo or other non-surgical therapies for the treatment of symptoms of gastro-oesophageal reflux in children. We searched MEDLINE, EMBASE, the Cochrane Controlled Trials Register, Science Citation Index and reference lists for randomized controlled trials which compared cisapride with placebo or other non-surgical therapy in children. We included only trials which reported reflux-related symptoms as an outcome, provided that cisapride was administered orally for at least I week. Seven trials (286 children in total) compared cisapride with placebo. Two trials reported good concealment of treatment allocation. The pooled odds ratio for the 'same or worse' symptoms was 0.34 (95% CI 0.10, 1.19). There was substantial heterogeneity between studies (P < 0.00001) and the funnel plot was asymmetrical. Adverse effects (mainly diarrhoea) were not significantly increased with cisapride (pooled odds ratio (OR) 1.80: 0.87, 3.70). The reflux index was significantly reduced in children treated with cisapride (weighted mean difference -6.49: -10.13, -2.85). One study (50 children) compared cisapride with gaviscon plus carobel: the OR for the 'same or worse' symptoms was 3.26 (0.93, 11.38). There was no clear evidence that cisapride reduced symptoms of gastro-oesophageal reflux. As smaller, poorer quality studies were biased in favour of a positive treatment effect, the pooled OR overestimated the potential benefits of cisapride. There was some evidence to suggest that gaviscon plus carobel may be a more effective option than cisapride.
Authors:
R E Gilbert; C Augood; S MacLennan; S Logan
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Journal of paediatrics and child health     Volume:  36     ISSN:  1034-4810     ISO Abbreviation:  J Paediatr Child Health     Publication Date:  2000 Dec 
Date Detail:
Created Date:  2000-12-20     Completed Date:  2001-02-01     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9005421     Medline TA:  J Paediatr Child Health     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  524-9     Citation Subset:  IM    
Affiliation:
Department of Paediatric Epidemiology and Biostatistics, Institute of Child Health, London, UK. r.gilbert@ich.ucl.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Child
Cisapride / therapeutic use*
Gastroesophageal Reflux / drug therapy*
Gastrointestinal Agents / therapeutic use*
Humans
Randomized Controlled Trials as Topic
Chemical
Reg. No./Substance:
0/Gastrointestinal Agents; 81098-60-4/Cisapride

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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