Prokinetic agents and laryngopharyngeal reflux disease: Prokinetic agents and laryngopharyngeal reflux disease: a systematic review.
OBJECTIVE
Our objective was to systematically identify and evaluate prospective studies providing evidence for and against the use of prokinetic agents in the treatment of laryngopharyngeal reflux (LPR) disease.


METHODS
Our data sources were PubMed, Embase, BIOSIS, and Web of Science databases.


METHODS
A systematic literature review was conducted to identify studies prospectively evaluating the effectiveness of prokinetic agents in the treatment of LPR. Data from eligible studies were independently extracted from each study by two authors. The primary outcome of interest was the improvement of LPR symptoms among study participants. Secondary outcomes included resolution of LPR physical signs and the development of side effects from therapy.


RESULTS
Among 724 unique articles identified, four studies met inclusion criteria. These four investigations provided mixed evidence about the effectiveness of prokinetic agents in the treatment of LPR. The studies included in the review were deemed to be at high risk of bias. Three of the four investigations demonstrated a statistically significant difference in patient symptoms that favored the use of prokinetics in the management of LPR. The investigations were mixed in their report of improvement in physical examination findings among patients receiving and those not receiving prokinetic medical therapy. No significant adverse effects were described in any of these trials.


CONCLUSIONS
Prokinetic agents may be a viable treatment option for LPR. The current body of literature is inadequate to make a recommendation for their use in this disease process. Further research should be conducted to assess the use of prokinetic medications in the management of LPR.
Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada.
Jordan T
JT
Glicksman
Paul T
PT
Mick
Kevin
K
Fung
Thomas L
TL
Carroll
D019468:Disease Management; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D057045:Laryngopharyngeal Reflux / Q000188:drug therapy*; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*
D005765:Gastrointestinal Agents; D054328:Proton Pump Inhibitors
Prokinetic agents; atypical reflux; extraesophageal reflux; gastroesophageal reflux; laryngopharyngeal reflux