Qi Qian, Wang Rugang, Liu Lin, Zhao Feng, Wang Sheng
Int J Clin Pharmacol Ther. 2015 Oct;53(10):803-10. doi: 10.5414/CP202396.
This study aims to evaluate the effectiveness and tolerability of esomeprazole and omeprazole in patients with gastroesophageal reflux disease (GERD). Electronic searches on PubMed, EMBASE, the Cochrane Library, and ClinicalTrials.gov databases were carried out for reports up to February 28, 2015. Ten eligible studies from 8 articles were found that enrolled a total of 10,286 patients for meta-analysis. These results revealed a significant difference between esomeprazole vs. omeprazole (RR=1.06, 95% CI [1.01, 1.10], I2=72%, p=0.01) by subgroup according to dosage by random effects model, and a significant difference between esomeprazole 40 mg vs. omeprazole 20 mg (RR=1.07, 95% CI [1.004, 1.14], I2=78%, p=0.04) based on healing rate as determined by endoscopy, using a random effects model. A significant difference between esomeprazole 20 mg and omeprazole 40 mg (RR=0.68, 95% CI [0.47, 0.97], I2=not applicable, p=0.03) was also found in comparing relief of symptoms by random effects model. There were no significant differences in outcomes between other subgroups, including tolerability. Based on these results, a high dose of esomeprazole is recommended for GERD treatment and control in adults.
本研究旨在评估埃索美拉唑和奥美拉唑对胃食管反流病（GERD）患者的有效性和耐受性。检索了PubMed、EMBASE、Cochrane图书馆和ClinicalTrials.gov数据库，以获取截至2015年2月28日的报告。从8篇文章中筛选出10项符合条件的研究，共纳入10286例患者进行荟萃分析。随机效应模型亚组分析结果显示，根据剂量，埃索美拉唑与奥美拉唑之间存在显著差异（RR = 1.06，95%CI [1.01, 1.10]，I2 = 72%，p = 0.01）；基于内镜检查确定的愈合率，使用随机效应模型，埃索美拉唑40mg与奥美拉唑20mg之间存在显著差异（RR = 1.07，95%CI [1.004, 1.14]，I2 = 78%，p = 0.04）。随机效应模型比较症状缓解情况时，还发现埃索美拉唑20mg与奥美拉唑40mg之间存在显著差异（RR = 0.68，95%CI [0.47, 0.97]，I2 = 不适用，p = 0.03）。其他亚组的结果，包括耐受性，均无显著差异。基于这些结果，推荐高剂量埃索美拉唑用于成人GERD的治疗和控制。
