Efficacy of Proton-Pump Inhibitors in Children With Gastroesophageal Reflux Disease: A Systematic Review: a systematic review

Rachel J. van der Pol; Marije J. Smits; Michiel P. van Wijk; Taher I. Omari; Merit M. Tabbers; Marc A. Benninga

doi:https://doi.org/10.1542/peds.2010-2719

Efficacy of Proton-Pump Inhibitors in Children With Gastroesophageal Reflux Disease: A Systematic Review: a systematic review

Rachel J. van der Pol, Marije J. Smits, Michiel P. van Wijk, Taher I. Omari, Merit M. Tabbers, Marc A. Benninga

Research output: Contribution to journal › Review article › Academic › peer-review

191 Citations (Scopus)

Abstract

INTRODUCTION: 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. OBJECTIVES: We performed a systematic review to determine effectiveness and safety of PPIs in children with GERD. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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. Pediatrics 2011; 127: 925-935

Original language	English
Pages (from-to)	925-935
Number of pages	11
Journal	Pediatrics
Volume	127
Issue number	5
DOIs	https://doi.org/10.1542/peds.2010-2719
Publication status	Published - May 2011

Keywords

2-Pyridinylmethylsulfinylbenzimidazoles/administration & dosage
Adolescent
Age Factors
Child
Child, Preschool
Cross-Over Studies
Dose-Response Relationship, Drug
Drug Administration Schedule
Female
Gastroesophageal Reflux/diagnosis
Humans
Incidence
Infant
Lansoprazole
Male
Netherlands
Omeprazole/administration & dosage
Prognosis
Proton Pump Inhibitors/administration & dosage
Randomized Controlled Trials as Topic
Risk Assessment
Treatment Outcome

Access to Document

https://doi.org/10.1542/peds.2010-2719

Cite this

@article{66f80fbafd8e4199b61c7e1630e5af55,

title = "Efficacy of Proton-Pump Inhibitors in Children With Gastroesophageal Reflux Disease: A Systematic Review: a systematic review",

abstract = "INTRODUCTION: 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. OBJECTIVES: We performed a systematic review to determine effectiveness and safety of PPIs in children with GERD. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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. Pediatrics 2011; 127: 925-935",

keywords = "2-Pyridinylmethylsulfinylbenzimidazoles/administration & dosage, Adolescent, Age Factors, Child, Child, Preschool, Cross-Over Studies, Dose-Response Relationship, Drug, Drug Administration Schedule, Female, Gastroesophageal Reflux/diagnosis, Humans, Incidence, Infant, Lansoprazole, Male, Netherlands, Omeprazole/administration & dosage, Prognosis, Proton Pump Inhibitors/administration & dosage, Randomized Controlled Trials as Topic, Risk Assessment, Treatment Outcome",

author = "{van der Pol}, {Rachel J.} and Smits, {Marije J.} and {van Wijk}, {Michiel P.} and Omari, {Taher I.} and Tabbers, {Merit M.} and Benninga, {Marc A.}",

year = "2011",

month = may,

doi = "https://doi.org/10.1542/peds.2010-2719",

language = "English",

volume = "127",

pages = "925--935",

journal = "Pediatrics",

issn = "0031-4005",

publisher = "American Academy of Pediatrics",

number = "5",

}

TY - JOUR

T1 - Efficacy of Proton-Pump Inhibitors in Children With Gastroesophageal Reflux Disease: A Systematic Review

T2 - a systematic review

AU - van der Pol, Rachel J.

AU - Smits, Marije J.

AU - van Wijk, Michiel P.

AU - Omari, Taher I.

AU - Tabbers, Merit M.

AU - Benninga, Marc A.

PY - 2011/5

Y1 - 2011/5

N2 - INTRODUCTION: 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. OBJECTIVES: We performed a systematic review to determine effectiveness and safety of PPIs in children with GERD. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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. Pediatrics 2011; 127: 925-935

AB - INTRODUCTION: 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. OBJECTIVES: We performed a systematic review to determine effectiveness and safety of PPIs in children with GERD. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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. Pediatrics 2011; 127: 925-935

KW - 2-Pyridinylmethylsulfinylbenzimidazoles/administration & dosage

KW - Adolescent

KW - Age Factors

KW - Child

KW - Child, Preschool

KW - Cross-Over Studies

KW - Dose-Response Relationship, Drug

KW - Drug Administration Schedule

KW - Female

KW - Gastroesophageal Reflux/diagnosis

KW - Humans

KW - Incidence

KW - Infant

KW - Lansoprazole

KW - Male

KW - Netherlands

KW - Omeprazole/administration & dosage

KW - Prognosis

KW - Proton Pump Inhibitors/administration & dosage

KW - Randomized Controlled Trials as Topic

KW - Risk Assessment

KW - Treatment Outcome

U2 - https://doi.org/10.1542/peds.2010-2719

DO - https://doi.org/10.1542/peds.2010-2719

M3 - Review article

C2 - 21464183

SN - 0031-4005

VL - 127

SP - 925

EP - 935

JO - Pediatrics

JF - Pediatrics

IS - 5

ER -