title: Meta-analysis: the efficacy of proton pump inhibitors for laryngeal symptoms attributed to gastro-oesophageal reflux disease.
abstract: BACKGROUND
  Many investigators have proposed an association between gastro-oesophageal reflux disease and laryngo-pharyngeal symptoms, suggesting that medical or surgical therapy for reflux may be useful.
  
  
  OBJECTIVE
  To perform a meta-analysis assessing the effectiveness of medical or surgical therapy for reflux disease in adult patients with laryngeal or pharyngeal symptoms presumed to be due to gastro-oesophageal reflux disease.
  
  
  METHODS
  Randomized controlled trials comparing medical or surgical treatments for gastro-oesophageal reflux disease against placebo were identified by searching MEDLINE (1966-September 2005), EMBASE (1974-September 2005), the CCRCT (until September 2005) and abstracts from gastroenterology and ENT meetings. The relative risks of reporting symptomatic improvement or resolution of symptoms was evaluated using a random-effects model.
  
  
  RESULTS
  Five studies using high-dose proton pump inhibitor as intervention met the inclusion criteria and were included in the meta-analysis. No surgical studies met inclusion criteria. The pooled relative risk was 1.18 (95% confidence interval: 0.81-1.74). There was no heterogeneity between studies but evidence of significant publication bias. Sub-group analysis performed evaluating Jadad scores and symptom type, did not change the relative risk.
  
  
  CONCLUSIONS
  Therapy with a high-dose proton pump inhibitor is no more effective than placebo in producing symptomatic improvement or resolution of laryngo-pharyngeal symptoms. Further studies are necessary to identify the characteristics of patients that may respond to proton pump inhibitor therapy.
authors.affiliation: Department of Internal Medicine and Gastroenterology, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Gatta
authors.forename: D
authors.initials: D
authors.lastname: Vaira
authors.forename: G
authors.initials: G
authors.lastname: Sorrenti
authors.forename: S
authors.initials: S
authors.lastname: Zucchini
authors.forename: C
authors.initials: C
authors.lastname: Sama
authors.forename: N
authors.initials: N
authors.lastname: Vakil
mesh_terms: D000328:Adult; D005764:Gastroesophageal Reflux / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007818:Laryngeal Diseases / Q000188:drug therapy* / Q000209:etiology; D007830:Larynx / Q000503:physiopathology*; D010919:Placebos; D054328:Proton Pump Inhibitors; D017494:Proton Pumps / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic
chemical_list: D010919:Placebos; D054328:Proton Pump Inhibitors; D017494:Proton Pumps