Proton pump inhibitors (PPI) therapy ‘on-demand' is often used as an alternative to continuous maintenance therapy in gastro-esophageal reflux disease (GERD).
Dr Pace and colleagues from Italy conducted a systematic review with the specific objectives to ascertain whether on-demand PPI therapy was effective in preventing symptomatic relapse.
The research team assessed the relative efficacy of on-demand vs continuous PPI maintenance strategy.
|17 trials compared on-demand PPI vs continuous PPI therapy for GERD|
|Alimentary Pharmacology & Therapeutics|
The team searched the Medline database, and the Cochrane Controlled Trials Register.
The researchers identified 17 randomized-controlled clinical trials comparing on-demand PPI vs placebo or on-demand vs continuous PPI therapy in GERD patients.
Out of the 17 studies, 5 investigated patients with non-erosive reflux disease.
A further 4 studies assessed patients with non-erosive reflux disease and mild esophagitis.
The team found 2 studies assessing patients with erosive esophagitis only, and 2 others included patients with uninvestigated GERD symptoms.
The team identified 4 further studies that were not investigating the effectiveness of the therapies but primarily pharmacoeconomic or quality of life parameters.
Dr Pace's team concluded , "On-demand therapy with currently available PPI appears to be effective in the long-term management of patients with non-erosive reflux disease or mild and uninvestigated forms of GERD, but not in patients with erosive esophagitis."