title: Meta-analysis used to identify factors associated with the effectiveness of proton pump inhibitors against non-erosive reflux disease.
abstract: BACKGROUND
  A lack of published data remains on factors associated with the treatment response to proton pump inhibitors (PPI) in patients with non-erosive reflux disease (NERD).
  
  
  METHODS
  Studies on effectiveness of PPI in patients with NERD were identified using the MEDLINE database and manual searches of the available literature. Twenty publications that comprised a total of 22 study arms were eligible, and meta-analyses of these 22 study arms were carried out.
  
  
  RESULTS
  Overall improvement rate in patients with PPI was 68%. Univariate meta-regression analysis was used to explore the source of heterogeneity, P-value for males was 0.192, and in the presence of Helicobacter pylori (H. pylori) infection was 0.186, indicating that these factors are associated with treatment effectiveness. Thus, as the frequency of male and H. pylori-infected patients increased, the effectiveness of PPI against NERD improved. By multivariate meta-regression analysis, the P-value for male and H. pylori infection decreased further (P = 0.002 and P = 0.003, respectively), indicating little interaction between male sex and H. pylori infection.
  
  
  CONCLUSIONS
  These results suggest that H. pylori infection and patient sex may be associated with the effectiveness of PPI against patients with NERD. The reasons are still unclear, and further examinations are needed to clarify them.
authors.affiliation: Health Service Center, Hiroshima University, Higashihiroshima, Japan. tohiyama@hiroshima-u.ac.jp
authors.forename: Toru
authors.initials: T
authors.lastname: Hiyama
authors.forename: Keitaro
authors.initials: K
authors.lastname: Matsuo
authors.forename: Yuji
authors.initials: Y
authors.lastname: Urabe
authors.forename: Tatsuma
authors.initials: T
authors.lastname: Fukuhara
authors.forename: Shinji
authors.initials: S
authors.lastname: Tanaka
authors.forename: Masaharu
authors.initials: M
authors.lastname: Yoshihara
authors.forename: Ken
authors.initials: K
authors.lastname: Haruma
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama
mesh_terms: D004942:Esophagitis, Peptic / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D005764:Gastroesophageal Reflux / Q000188:drug therapy* / Q000382:microbiology; D016481:Helicobacter Infections / Q000382:microbiology; D016480:Helicobacter pylori / Q000472:pathogenicity; D006801:Humans; D008297:Male; D018579:Patient Selection; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D012737:Sex Factors; D016896:Treatment Outcome
chemical_list: D054328:Proton Pump Inhibitors