Proton pump inhibitors (PPIs) are often taken for short-term treatment of heartburn.
Dr McQuaid and Dr Laine from California performed a systematic review of the efficacy of PPIs for heartburn relief within the first 1 to 2 days of therapy.
The researchers searched bibliographic databases for clinical trials of PPIs in patients with heartburn.
|Meta-analyses was performed on 18 randomized trial comparisons of PPIs|
|Clinical Gastroenterology & Hepatology|
The team looked for clinical trials that provided information about the proportion with heartburn relief at day 1 to 2.
The research team calculated the sample size-weighted pooled proportions of patients with complete or sustained relief for 7 consecutive days.
The researchers also performed meta-analyses of randomized comparisons of PPIs.
The team reported that 18 trials met the inclusion criteria.
The researchers found that at day 1 of PPI therapy, complete 24-hour, daytime, nighttime, and sustained heartburn relief occurred in 0.3, 0.5, 0.6, and 0.2 of patients.
The team observed that up to 37% of the heartburn relief achievable with 28 days of PPIs occurred on day 1.
Placebo was significantly less effective than PPIs for 24-hour relief on day 1, and single-dose PPI therapy was less effective than double-dose therapy.
Dr McQuaid and colleague concludes, “Complete heartburn relief for the entire day occurs in approximately 30% of patients after their first PPI dose and 9% of patients after their first placebo.”
“Although PPIs might provide benefit from the first day of therapy, most patients will not have symptom relief with 1 or 2 days of PPI therapy.”