Proton Pump Inhibitor Therapy for the Treatment of Laryngopharyngeal Reflux: A Meta-Analysis of Randomized Controlled Trials.

GOALS

To compare the treatment effect of proton pump inhibitor (PPI) therapy and placebo for patients with laryngopharyngeal reflux (LPR).

STUDY

PubMed, Cochrane Library, and EMBASE were searched from the date of conception to August 2014. Randomized controlled clinical trials (RCTs) were included in this meta-analysis if they compared the treatment response of PPI therapy and placebo among patients with LPR. The risk difference, the standard mean difference (SMD), and their corresponding 95% confidence intervals (CIs) were calculated for the endpoints evaluated.

RESULTS

Fourteen eligible RCTs with 771 participants were identified and analyzed in this meta-analysis. By pooling all eligible data, we found that patients treated with PPI therapy had a significantly higher response rate than those who received placebo (risk difference=0.15; 95% CI, 0.01-0.30). Compared with placebo, PPI therapy could also improve the total reflux symptom index significantly (SMD=1.65; 95% CI, 0.15-3.14), but results of the reflux symptom index varied for specific symptoms. However, PPI therapy did not show any advantage over placebo in the improvement of the reflux finding score (SMD=0.62; 95% CI, -0.96-2.19).

CONCLUSIONS

In this meta-analysis of 14 eligible RCTs, we found that in patients with LPR, PPI therapy could improve reflux symptoms significantly compared with placebo.