Document Detail


Efficacy of proton-pump inhibitors in children with gastroesophageal reflux disease: a systematic review.
MedLine Citation:
PMID:  21464183     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Use of proton-pump inhibitors (PPIs) for the treatment of gastroesophageal reflux disease (GERD) in children has increased enormously. However, effectiveness and safety of PPIs for pediatric GERD are under debate.
OBJECTIVES: We performed a systematic review to determine effectiveness and safety of PPIs in children with GERD.
METHODS: We searched PubMed, Embase, and the Cochrane Database of Systematic Reviews for randomized controlled trials and crossover studies investigating efficacy and safety of PPIs in children aged 0 to 18 years with GERD for reduction in GERD symptoms, gastric pH, histologic aberrations, and reported adverse events.
RESULTS: Twelve studies were included with data from children aged 0-17 years. For infants, PPIs were more effective in 1 study (compared with hydrolyzed formula), not effective in 2 studies, and equally effective in 2 studies (compared with placebo) for the reduction of GERD symptoms. For children and adolescents, PPIs were equally effective (compared with alginates, ranitidine, or a different PPI dosage). For gastric acidity, in infants and children PPIs were more effective (compared with placebo, alginates, or ranitidine) in 4 studies. For reducing histologic aberrations, PPIs showed no difference (compared with ranitidine or alginates) in 3 studies. Six studies reported no differences in treatment-related adverse events (compared with placebo or a different PPI dosage).
CONCLUSIONS: PPIs are not effective in reducing GERD symptoms in infants. Placebo-controlled trials in older children are lacking. Although PPIs seem to be well tolerated during short-term use, evidence supporting the safety of PPIs is lacking.
Authors:
Rachel J van der Pol; Marije J Smits; Michiel P van Wijk; Taher I Omari; Merit M Tabbers; Marc A Benninga
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Publication Detail:
Type:  Journal Article; Review     Date:  2011-04-04
Journal Detail:
Title:  Pediatrics     Volume:  127     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-05-02     Completed Date:  2011-07-11     Revised Date:  2013-06-04    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  925-35     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital/Academic Medical Center, Meibergdreef 9, C2-312, 1105 AZ Amsterdam, Netherlands. r.j.vanderpol@amc.nl
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MeSH Terms
Descriptor/Qualifier:
2-Pyridinylmethylsulfinylbenzimidazoles / administration & dosage,  adverse effects
Adolescent
Age Factors
Child
Child, Preschool
Cross-Over Studies
Dose-Response Relationship, Drug
Drug Administration Schedule
Female
Gastroesophageal Reflux / diagnosis*,  drug therapy*,  epidemiology
Humans
Incidence
Infant
Male
Netherlands
Omeprazole / administration & dosage,  adverse effects
Prognosis
Proton Pump Inhibitors / administration & dosage*,  adverse effects
Randomized Controlled Trials as Topic
Risk Assessment
Treatment Outcome
Chemical
Reg. No./Substance:
0/2-Pyridinylmethylsulfinylbenzimidazoles; 0/Proton Pump Inhibitors; 103577-45-3/lansoprazole; 73590-58-6/Omeprazole; D8TST4O562/pantoprazole

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


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