Effects of Proton-Pump Inhibitors on Functional Dyspepsia: A Meta-analysis of Randomized Placebo-Controlled Trials

2007 ◽  
Vol 5 (2) ◽  
pp. 178-185 ◽  
Author(s):  
Wei Hong Wang ◽  
Jia Qing Huang ◽  
Ge Fan Zheng ◽  
Harry H.X. Xia ◽  
Wai Man Wong ◽  
...  
Keyword(s):  
Functional Dyspepsia ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Meta Analysis ◽  
Controlled Trials

scholarly journals Association between Proton Pump Inhibitors and Respiratory Infections: A Systematic Review and Meta-Analysis of Clinical Trials

2008 ◽  
Vol 22 (9) ◽  
pp. 761-766 ◽  
Author(s):  
Nabil Sultan ◽  
Jose Nazareno ◽  
James Gregor
Keyword(s):  
Respiratory Infection ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Respiratory Infections ◽  
Bacterial Colonization ◽  
Meta Analysis ◽  
Gastrointestinal Diseases ◽  
Controlled Trials ◽  
High Dose ◽  
Increased Risk

BACKGROUND: Proton pump inhibitors (PPIs) have become the mainstay of treatment for and prevention of many serious gastrointestinal diseases. Laboratory and clinical evidence suggests that the increase in gastric pH caused by PPIs may be linked to increased bacterial colonization of the stomach and may predispose patients to an increased risk for respiratory infections.OBJECTIVE: To examine the association between PPI treatment and respiratory infections.METHODS: A literature search was conducted using PubMed, MEDLINE and Cochrane databases of randomized, placebo-controlled trials evaluating the efficacy of PPIs. Studies that listed and quantified the specific adverse events of ‘respiratory infection’ or ‘upper respiratory infection’ (or equivalent), and compared their rates between PPIs and placebo were included. The χ2analysis was used to calculate the significance of association in individual studies and a meta-analysis of the selected studies was performed.RESULTS: Of 7457 studies initially identified and 70 relevant randomized, controlled trials (RCTs) selected, seven studies met the inclusion criteria. A total of 16 comparisons for χ2analysis were possible given the multiple dosage arms used in several studies. PPIs included in the studies were esomeprazole, rabeprazole, pantoprazole and omeprazole. More than one-half of the studies showed a trend toward an association between PPI use and respiratory infections, although the majority of the studies failed to show a significant correlation. A single study using high-dose esomeprazole (40 mg) showed a significant association – 4.3% rate of respiratory infections in the active group compared with 0% in the placebo group (P<0.05). Meta-analysis showed a trend toward an association between PPIs and respiratory infections, although it failed to reach significance (OR 1.42, 95% CI 0.86 to 2.35; P=0.17).CONCLUSION: Although a trend was evident in both a χ2analysis of individual studies and a meta-analysis, the present review and meta-analysis failed to show a conclusive association between PPIs and respiratory infections. Very few RCTs actively sought out respiratory infections, which excluded the majority of RCTs identified. A well-structured, placebo-controlled prospective study would be needed to determine whether a true association between PPIs and respiratory infections exists.

Effect of Proton-Pump Inhibitors on Glucose and Insulin Metabolism on Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Vol 26 (32) ◽  
pp. 4007-4013
Author(s):  
Adriana Sánchez-García ◽  
Mario Simental-Mendía ◽  
Luis E. Simental-Mendía
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Randomized Controlled Trials ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Insulin Metabolism ◽  
Randomized Controlled

Background: Some studies have revealed an improvement in glucose metabolism after proton-pump inhibitors (PPI) therapy; however, this evidence is inconclusive and limited. Objective: The study aimed to examine the effect of PPI on glucose and insulin metabolism in patients with type 2 diabetes through a systematic review and meta-analysis. Methods: Only randomized controlled trials evaluating the impact of PPI on glucose or insulin concentrations in type 2 diabetes were searched in PubMed-Medline, SCOPUS, Web of Science and Google Scholar databases. A meta-analysis was conducted using a random-effects model and generic inverse variance method. Sensitivity analysis was performed using the leave-one-out method. Results: Meta-analysis revealed no significant effect of PPI intervention on fasting glucose (mean difference [MD] -11.42 [95% CI, -29.68 to 6.83], I2 = 80%, p = 0.22), fasting insulin (MD 1.51 [95% CI, -0.36 to 3.37], I2 = 32%, p = 0.11), HOMA-IR (MD -0.16 [-0.98 to 0.65], I2 = 0%, p = 0.70), HOMA-β (MD 19.97 [-21.59 to 61.52], I2 = 71%, p = 0.35), and HbA1c concentrations (MD -0.34 [-0.99 to 0.31], I2 = 89%, p = 0.30). Conclusion: The treatment with PPI, in the short term, had no significant effects on glucose and insulin metabolism in patients with type 2 diabetes.

scholarly journals Chinese herbal medicine for functional dyspepsia: systematic review of systematic reviews

2018 ◽  
Vol 11 ◽  
pp. 175628481878557 ◽  
Author(s):  
Michael H. K. Chu ◽  
Irene X. Y. Wu ◽  
Robin S. T. Ho ◽  
Charlene H. L. Wong ◽  
Anthony L. Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Herbal Medicine ◽  
Functional Dyspepsia ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Chinese Herbal Medicine ◽  
Meta Analysis ◽  
Chinese Herbal ◽  
Dyspeptic Symptoms ◽  
Meta Analyses

Background: Pharmacotherapy, including prokinetics and proton pump inhibitors for functional dyspepsia (FD) have limited effectiveness, and their safety has been recently questioned. Chinese herbal medicine (CHM) could be considered as an alternative. A systematic review (SR) of SRs was performed to evaluate the potential effectiveness and safety of CHM. Method: We conducted a comprehensive literature search for SRs with meta-analyses in eight international and Chinese databases. Pooled effect estimation from each meta-analysis was extracted. The AMSTAR instrument was used to assess the methodological quality of the included SRs. Results: A total of 14 SRs of mediocre quality assessing various CHMs, alone or in combination with conventional pharmacotherapy, were included. Meta-analyses showed that CHM was more effective than prokinetic agents for the alleviation of global dyspeptic symptoms. Three specific CHM formulae appeared to show superior results in the alleviation of global dyspeptic symptoms, including Si Ni San, modified Xiao Yao San and Xiang Sha Liu Jun Zi decoction. No significant difference in the occurrence of adverse events in using CHM or pharmacotherapy was reported. Conclusion: CHM can be considered as an alternative for the treatment of FD symptoms when prokinetic agents and proton pump inhibitors are contraindicated. Future trial design should focus on measuring changes in individual dyspeptic symptoms and differentiate the effectiveness of different CHM for postprandial distress syndrome and epigastric pain syndrome. A network meta-analysis approach should be used to explore the most promising CHM formula for FD treatment in the future.

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