Meta-Analysis For Efficacy And Safety Of Gastroesophageal Reflux Disease Treated By Lansoprazole

ObjectiveTo systematically evaluate therapeutic efficacy and safety of lansopr azole vs.other proton pump inhibitors in the treatment of gastroesophagea 1 reflux disease (GERD), provide evidence-based support for the clinical application of proton pump inhibitors(PPI).MethodsRetrieved CNKI, Wanfang, VIP, PubMed, Medline, Cochrane Library for random ized controlled trials (RCT) that compare the efficacy of lansoprazole and other proton pump inhibitors in the treatment of GERD, according to the i nclusion and exclusion criteria, clinical symptom remission rate and endoc opic cure rate and the incidence of adverse reactions were the evaluation index, improved Jadad score method is adopted to qualify the inclusion st udy and use meta-analysis software RevMan5.0 in Cochrane Collaboration to data processing and analysis.ResultsA total of 13 Chinese RCT and 8 English RCT were included, involving 9 583 patients,4562 in the treatment group and 5021 in the control group. Re suits of Meta-analysis showed that:there were no difference in the clini cal symptom remission rate at 4 weeks between lansoprazole, omeprazole [0 R= 0.91,95% CI (0.54,1.53), P=0.72], and rabeprazole[OR=0.53,95%CI (0.27,1. 02), P=0.06], but lansoprazole not as good as esomeprazole[OR=0.43,95%CI(0. 28,0.64), P<0.0001], only one RCT compared with pantoprazole,no difference between the results; There were no difference in the clinical symptom rem ission rate at 8 weeks between lansoprazole, omeprazole [OR= 0.81,95% CI (0.37,1.81), P=0.61], and rabeprazole[OR=0.59,95%CI(0.26,1.37), P=0.22],but lansoprazole not as good as esomeprazole[OR=0.38,95%CI (0.24,0.62),P<0.00 01], there was no RCT compared with pantoprazole; There were no difference in the endoscopic cure rate at 4 weeks between lansoprazole, omeprazole[OR =1.13,95%CI (0.94,1.37), P=0.20], pantoprazole[OR=0.95,95%CI (0.63,1.44), P=0. 81], but lansoprazole not as good as rabeprazole [OR=0.38,95%CI (0.16,0.8 9), P=0.03], esomeprazole[OR=0.52,95%CI(0.35,0.77), P=0.001]; There were nod ifference in the endoscopic cure rate at 8 weeks between lansoprazole, ome prazole [OR=1.06,95%CI (0.85,1.32), P=0.60], pantoprazole[OR=0.72,95%CI (0.44, 1.16), P=0.18], but lansoprazole not as good as rabeprazole[OR=0.44,95%CI (0.22,0.85), P=0.01], esomeprazole[OR=0.59,95%CI(0.50,0.69), P<0.0001]. Ther e were no difference in the incidence of rash between lansoprazole and om eprazole[OR=2.35,95%CI(0.33,16.57),P=0.39];There were no difference inthe incidence of gastrointestinal reaction between lansoprazole%omeprazole[0 R=1.15,95%CI (0.82,1.62), P=0.42], rabeprazole [OR=3.15,95%CI (0.47,20.98), P= 0.24] and esomeprazole [OR=1.08,95%CI (0.92,1.26),P=0.36]; There wereno di fference in the incidence of headache or dizzy between lansoprazoleand om eprazole[OR=1.06,95%CI(0.74,1.52),P=0.75], but the incidence is lowerthan esomeprazole[OR=0.77,95%CI(0.60,0.98), P=0.03].Conclusion1. In the treatment of GERD, there were no difference in the clinical s ymptom remission rate wether at 4 weeks or 8weeks between lansoprazole, om eprazole and rabeprazole, but lansoprazole not as good as esomeprazole. Th ere is a lack of literature that comparing the clinical symptom remission rate between lansoprazole and pantoprazole, so can not assess whether ther e are differences.2. In the treatment of GERD, there were no difference in the endoscopic cure rate wether at 4 weeks or 8weeks between lansoprazole, omeprazole and pantoprazole,but lansoprazole not as good as esomeprazole, rabeprazole.3. Rash, headache, dizziness, gastrointestinal tract reaction are the common adverse reactions in the process of the treatment of gastroesophag eal reflux disease by PPI. But there are no distinct difference in the inc idence of adverse reactions between lansoprazole and other PPIs.4. Due to the low quality of the included Chinese study, large scale, multiplecent-er studies are required to validate this conclusions.