Edwards S J, Lind T, Lundell L
Outcomes Research, AstraZeneca UK Ltd, Luton, Bedfordshire, UK.
Aliment Pharmacol Ther. 2006 Sep 1;24(5):743-50. doi: 10.1111/j.1365-2036.2006.03074.x.
No randomized controlled trial has compared all the licensed standard dose proton pump inhibitors in the healing of reflux oesophagitis.
To compare the effectiveness of esomeprazole with licensed standard dose proton pump inhibitors for healing of reflux oesophagitis (i.e. lansoprazole 30 mg, omeprazole 20 mg, pantoprazole 40 mg and rabeprazole 20 mg).
Systematic review of CENTRAL, BIOSIS, EMBASE and MEDLINE for randomized controlled trials in patients with reflux oesophagitis. Searching was completed in February 2005. Data on endoscopic healing rates at 4 and 8 weeks were extracted and re-analysed if not analysed by intention-to-treat. Meta-analysis was conducted using a fixed effects model.
Of 133 papers identified in the literature search, six were of sufficient quality to be included in the analysis. No studies were identified comparing rabeprazole with esomeprazole. A meta-analysis of healing rates of esomeprazole 40 mg compared with standard dose proton pump inhibitors gave the following results: at 4 weeks [relative risk (RR) 0.92; 95% CI: 0.90, 0.94; P < 0.00001], and 8 weeks (RR 0.95; 95% CI: 0.94, 0.97; P < 0.00001). Publication bias did not have a significant impact on the results. The results were robust to changes in the inclusion/exclusion criteria and using a random effects model.
Esomeprazole consistently demonstrates higher healing rates when compared with standard dose proton pump inhibitors.
尚无随机对照试验比较所有已获许可的标准剂量质子泵抑制剂在反流性食管炎愈合方面的效果。
比较埃索美拉唑与已获许可的标准剂量质子泵抑制剂（即兰索拉唑30毫克、奥美拉唑20毫克、泮托拉唑40毫克和雷贝拉唑20毫克）在反流性食管炎愈合方面的有效性。
对CENTRAL、BIOSIS、EMBASE和MEDLINE进行系统评价，以查找反流性食管炎患者的随机对照试验。检索于2005年2月完成。提取4周和8周时内镜愈合率的数据，若未按意向性治疗分析，则重新进行分析。采用固定效应模型进行荟萃分析。
在文献检索中识别出的133篇论文中，有6篇质量足够高可纳入分析。未找到比较雷贝拉唑与埃索美拉唑的研究。对40毫克埃索美拉唑与标准剂量质子泵抑制剂的愈合率进行荟萃分析，结果如下：4周时[相对危险度（RR）0.92；95%可信区间（CI）：0.90，0.94；P<0.00001]，8周时（RR 0.95；95%CI：0.94，0.97；P<0.00001）。发表偏倚对结果无显著影响。结果对纳入/排除标准的变化以及使用随机效应模型具有稳健性。
与标准剂量质子泵抑制剂相比，埃索美拉唑始终显示出更高的愈合率。
