Meta-analysis Of The Efficacy Of Proton Pump Inhibitors For The Laryngopharyngeal Reflux Disease

OBJECTIVE The study aimed to perform a systematic review and metaanalysis to explore validity and reliability of proton pump inhibitors(PPI)in adult patients with laryngopharyngeal reflux disease(LPRD),for management of throat symptoms,especially cough and hoarseness.METHODS Randomized and placebocontrolled clinical trials regarding the effectiveness of PPIs on LPRD patients were systematically extracted from PubMed,Cochrane Library,EMBASE,Web of Science,CNKI,CBM,VIP and WANFANG from the beginning of indexing to August 2017.After selection and quality assessment,data were independently extracted from eligible studies meeting the exclusion and inclusion criteria by 3 investigators.The Review Manager software(version 5.2,The Cochrane Collaboration)was performed for all of the statistical analysis in this meta-analysis.The level of evidence was assessed by the GRADE.RESULTS The sample comprised 14 RCTs including a pooled total of 815 LPR patients were eligible for this meta-analysis,of which 438 and 377 patients took PPIs and placebo,respectively.Pooled results demonstrated that total RSI significantly improved for patients who received PPI therapy by comparing with those receiving placebo [SDM=2.12,95% CI(0.80,3.45),P<0.05].PPI treatment group showed effective in response rate [OR=1.62,95% CI(0.89,2.95),P>0.05],but the differences between PPIs and placebo groups was not statistically significant.No obvious differences were found in the remission rate of cough [SDM=-0.12,95% CI(-1.44,1.19),P > 0.05]and hoarseness [SDM=-0.51,95% CI(-1.36,0.35),P>0.05].CONCLUSION PPI treatment could significantly improve reflux symptoms in LPRD patients and we found a strong placebo effect,therefore,should be taken into consideration for LPRD management with other strategies,such as lifestyle modification.Alleviating recurrent laryngopharyngeal symptoms and recurrence rate through diet adjustment and lifestyle improvement.