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Meta-analysis: the effects of placebo treatment on gastro-oesophageal... » Isaúde
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Alimentary Pharmacology and Therapeutics
2010-03-26 16:41:00

Meta-analysis: the effects of placebo treatment on gastro-oesophageal reflux disease

Descrição: Aliment Pharmacol Ther 2010; 32: 29[ndash]42Background There appears to be a significant placebo response rate in clinical trials for gastro-oesophageal reflux disease. Little is known about the determinants and the circumstances associated with placebo response in the treatment of gastro-oesophageal reflux disease (GERD).Aims To estimate the magnitude of the placebo response rate in randomized controlled trials for GERD and to identify factors that influence this response.Methods A meta-analysis of randomized, double-blind, placebo-controlled trials, published in English language, which included >20 patients with GERD, treated with either a proton pump inhibitor or H2-receptor antagonist for at least 2 weeks. Medline, Cochrane and EMBASE databases were searched, considering only studies that reported a global response for 'heartburn'.Results A total of 24 studies included 9989 patients with GERD. The pooled odds ratio (OR) for response to active treatment vs. placebo was 3.71 (95% CI: 2.78[ndash]4.96). The pooled estimate of the overall placebo response was 18.85% (range 2.94%[ndash]47.06%). Patients with erosive oesophagitis had a non-significantly lower placebo response rate than patients without it (11.87% and 18.31%, respectively; P = 0.246). Placebo response was significantly lower in studies of PPI therapy vs. studies of H2 RAs (14.51% vs. 24.69%, respectively; P = 0.05).Conclusions The placebo response rate in randomized controlled trials for GERD is substantial. A lower placebo response was associated with the testing of PPIs, but not the presence of erosive oesophagitis.

Identificador: 10.1111/j.1365-2036.2010.04315.x
Editorial: John Wiley & Sons, Inc.
Seção: Meta-analysis
Volume: 0
Página: 29 a 42
Autor: F. Cremonini, D. C. Ziogas, H. Y. Chang, E. Kokkotou, J. M. Kelley, L. Conboy, T. J. Kaptchuk, A. J. Lembo


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