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Type: Journal article
Title: Efficacy of proton-pump inhibitors in children with gastroesophageal reflux disease: A systematic review
Author: van der Pol, R.
Smits, M.
van Wijk, M.
Omari, T.
Tabbers, M.
Benninga, M.
Citation: Pediatrics, 2011; 127(5):925-935
Publisher: Amer Acad Pediatrics
Issue Date: 2011
ISSN: 0031-4005
Statement of
Rachel J. van der Pol, Marije J. Smits, Michiel P. van Wijk, Taher I. Omari, Merit M. Tabbers and Marc A. Benninga
Abstract: <h4>Introduction</h4>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.<h4>Objectives</h4>We performed a systematic review to determine effectiveness and safety of PPIs in children with GERD.<h4>Methods</h4>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.<h4>Results</h4>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).<h4>Conclusions</h4>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.
Keywords: systematic review; gastroesophageal reflux disease; efficacy; safety; proton-pump inhibitors; children
Rights: Copyright © 2011 by the American Academy of Pediatrics
RMID: 0020106654
DOI: 10.1542/peds.2010-2719
Appears in Collections:Paediatrics publications

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