Pharmacological interventions for non-ulcer dyspepsia.

Abstract:

BACKGROUND:The commonest cause of upper gastrointestinal symptoms is non-ulcer dyspepsia (NUD) and yet the pathophysiology of this condition has been poorly characterised and the optimum treatment is uncertain. It is estimated that pound450 million is spent on dyspepsia drugs in the UK each year. OBJECTIVES:This review aims to determine the effectiveness of six classes of drugs (antacids, histamine H2 antagonists, proton pump inhibitors, prokinetics, mucosal protecting agents and antimuscarinics) in the improvement of either the individual or global dyspepsia symptom scores and also quality of life scores patients with non-ulcer dyspepsia. SEARCH STRATEGY:Trials were located through electronic searches of the Cochrane Controlled Trials Register (CCTR), MEDLINE, EMBASE, CINAHL and SIGLE, using appropriate subject headings and text words, searching bibliographies of retrieved articles, and through contacts with experts in the fields of dyspepsia and pharmaceutical companies. SELECTION CRITERIA:All randomised controlled trials (RCTs) comparing drugs of any of the six groups with each other or with placebo for non-ulcer dyspepsia (NUD). DATA COLLECTION AND ANALYSIS:Data were collected on dyspeptic symptom scores either individual or global symptom assessments and also quality of life scores and adverse effects. MAIN RESULTS:A total of 11775 citations were obtained. 144 trials were retrieved and 94 trials fulfilled our eligibility criteria. However, subsequent data extraction was not possible in 37 trials. Fifty trials were excluded as they did not meet our eligibility criteria. The final 57 trials were included in the final meta-analysis. Prokinetics (12 trials with dichotomous outcomes generating 829 patients; relative risk reduction [RRR] = 50%; 95% confidence intervals [CI] = 30 to 65%) and H2RAs (8 trials generating 1,125 patients; RRR = 30%; 95% CI = 4 to 48%) were significantly more effective than placebo. Proton pump inhibitors (4 trials generating 1,248 patients; RRR = 12%; 95% CI = -1 to 24%) and Bismuth salts (6 trials generating 311 patients; RRR = 40%; 95% CI = -3 to 65%) were superior to placebo but this was of marginal statistical significance. Antacids (one trial generating 109 patients; RRR = -2%; 95% CI = -36% to 24%) and sucralfate (two trials generating 246 patients; RRR = 29%; 95% CI = -40% to 64%) were not statistically significantly superior to placebo. A funnel plot suggested that the prokinetic result could be due to publication bias. The funnel plot of H2RAs did not show any evidence of publication bias but the quality of the trials was generally poor. REVIEWER'S CONCLUSIONS:There is some evidence that anti-secretory therapy may be effective in NUD. The trials evaluating prokinetic therapy are difficult to interpret as the meta-analysis result could have been due to publication bias. Further research using prokinetics and anti-secretory therapy is required before any firm conclusions can be reached. The effect of these drugs is likely to be small and many patients will need to take them on a long-term basis so the therapies assessed need to be inexpensive and well tolerated.

authors

Soo S,Moayyedi P,Deeks J,Delaney B,Innes M,Forman D

doi

10.1002/14651858.CD001960

keywords:

subject

Has Abstract

pub_date

2000-01-01 00:00:00

pages

CD001960

issue

2

issn

1469-493X

pii

CD001960

pub_type

杂志文章,评审
  • Glucocorticoids for croup in children.

    abstract:BACKGROUND:Glucocorticoids are commonly used for croup in children. This is an update of a Cochrane Review published in 1999 and previously updated in 2004 and 2011. OBJECTIVES:To examine the effects of glucocorticoids for the treatment of croup in children aged 0 to 18 years. SEARCH METHODS:We searched the Cochrane ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析

    doi:10.1002/14651858.CD001955.pub4

    authors: Gates A,Gates M,Vandermeer B,Johnson C,Hartling L,Johnson DW,Klassen TP

    更新日期:2018-08-22 00:00:00

  • Intensity of exercise for the treatment of osteoarthritis.

    abstract:BACKGROUND:Therapeutic exercise is used as one modality to treat people with osteoarthritis (OA). OBJECTIVES:To evaluate the effectiveness of therapeutic exercise of differing intensities on objective and subjective measures of disease activity in people with OA. SEARCH STRATEGY:We searched MEDLINE, EMBASE, Pedro, Cu...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD004259

    authors: Brosseau L,MacLeay L,Robinson V,Wells G,Tugwell P

    更新日期:2003-01-01 00:00:00

  • Respiratory muscle training for cervical spinal cord injury.

    abstract:BACKGROUND:Cervical spinal cord injury (SCI) severely comprises respiratory function due to paralysis and impairment of the respiratory muscles. Various types of respiratory muscle training (RMT) to improve respiratory function for people with cervical SCI have been described in the literature. A systematic review of t...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD008507.pub2

    authors: Berlowitz DJ,Tamplin J

    更新日期:2013-07-23 00:00:00

  • Non-legislative interventions for the promotion of cycle helmet wearing by children.

    abstract:BACKGROUND:Helmets reduce bicycle-related head injuries, particularly in single vehicle crashes and those where the head strikes the ground. We aimed to identify non-legislative interventions for promoting helmet use among children, so future interventions can be designed on a firm evidence base. OBJECTIVES:To assess ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD003985.pub3

    authors: Owen R,Kendrick D,Mulvaney C,Coleman T,Royal S

    更新日期:2011-11-09 00:00:00

  • Hyperbaric oxygen therapy for thermal burns.

    abstract:BACKGROUND:Hyperbaric oxygen therapy (HBOT) consists of intermittently administering 100% oxygen at pressures greater than 1 atmosphere in a pressure vessel. This technology has been used to treat a variety of disease states and has been described as helping patients who have sustained burns. OBJECTIVES:The aim of thi...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD004727.pub2

    authors: Villanueva E,Bennett MH,Wasiak J,Lehm JP

    更新日期:2004-01-01 00:00:00

  • Anticholinergic therapy for chronic asthma in children over two years of age.

    abstract:BACKGROUND:In the intrinsic system of controlling airway calibre, the cholinergic (muscarinic) sympathetic nervous system has an important role. Anticholinergic, anti muscarinic bronchodilators such as ipratropium bromide are frequently used in the management of childhood airway disease. In asthma, ipratropium is a les...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD003535

    authors: McDonald NJ,Bara AI

    更新日期:2003-01-01 00:00:00

  • Coenzyme Q10 for Parkinson's disease.

    abstract:BACKGROUND:A number of preclinical studies in both in vitro and in vivo models of Parkinson's disease have demonstrated that coenzyme Q10 can protect the nigrostriatal dopaminergic system. Some clinical trials have looked at the neuroprotective effects of coenzyme Q10 in patients with early and midstage Parkinson's dis...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD008150.pub2

    authors: Liu J,Wang L,Zhan SY,Xia Y

    更新日期:2011-12-07 00:00:00

  • Circulatory volume expansion for aneurysmal subarachnoid hemorrhage.

    abstract:BACKGROUND:Patients with subarachnoid haemorrhage who develop spasm of the cerebral arteries may suffer from delayed cerebral ischaemia. This may be exacerbated by reduced circulatory volume. Intravenous fluid therapy to expand the circulating volume might reduce the risk of delayed cerebral ischaemia and so reduce the...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD000483

    authors: Feigin VL,Rinkel GJ,Algra A,van Gijn J

    更新日期:2000-01-01 00:00:00

  • Beta2-agonists for acute bronchitis.

    abstract:BACKGROUND:There are no clearly effective treatments for the cough of acute bronchitis, and beta2-agonists are often prescribed, perhaps because clinicians suspect many patients also have reversible airflow restriction contributing to the symptoms. OBJECTIVES:To determine whether beta2-agonists improve symptoms of acu...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD001726.pub3

    authors: Smucny J,Becker L,Glazier R

    更新日期:2006-10-18 00:00:00

  • Mobile bearing vs fixed bearing prostheses for total knee arthroplasty for post-operative functional status in patients with osteoarthritis and rheumatoid arthritis.

    abstract:BACKGROUND:The polyethylene insert in a total knee replacement (TKR) can be fixed to the tibial plateau or it can have freedom of rotation and / or translation. It is not yet clear whether there are differences in functional or clinical results between the two prosthesis types. OBJECTIVES:The goal of this review is to...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD003130.pub2

    authors: Jacobs W,Anderson P,Limbeek J,Wymenga A

    更新日期:2004-01-01 00:00:00

  • Embolisation for pulmonary arteriovenous malformation.

    abstract:BACKGROUND:Pulmonary arteriovenous malformations are abnormal direct connections between the pulmonary artery and pulmonary vein which result in a right-to-left shunt. They are associated with substantial morbidity and mortality mainly from the effects of paradoxical emboli. Potential complications include stroke, cere...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD008017.pub4

    authors: Hsu CC,Kwan GN,Thompson SA,Evans-Barns H,van Driel ML

    更新日期:2015-01-29 00:00:00

  • Interleukin-1 inhibitors for acute gout.

    abstract:BACKGROUND:Acute gout flares cause significant pain and disability and it is important to provide quick and effective pain relief. Traditional options for managing acute flares include colchicine, non-steroidal anti-inflammatory drugs (NSAIDs) and glucocorticoids. OBJECTIVES:To assess the benefits and harms of interle...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD009993.pub2

    authors: Sivera F,Wechalekar MD,Andrés M,Buchbinder R,Carmona L

    更新日期:2014-09-01 00:00:00

  • Laser photocoagulation for choroidal neovascularisation in pathologic myopia.

    abstract:BACKGROUND:Pathologic myopia is usually defined as the need for a spectacle correction of -6 diopters or higher. Choroidal neovascularisation (CNV) is the most commonly occurring cause of visual loss in people with pathologic myopia. In myopic macular degeneration the occurrence of newly formed vessels in the macula of...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD004765.pub2

    authors: Virgili G,Menchini F

    更新日期:2005-10-19 00:00:00

  • Interventions for the treatment of Paget's disease of the vulva.

    abstract:BACKGROUND:Extra-mammary Paget's disease is a rare form of superficial skin cancer. The most common site of involvement is the vulva. It is seen mainly in postmenopausal white women. Paget's disease of the vulva often spreads in an occult fashion, with margins extending beyond the apparent edges of the lesion. There is...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD009245.pub2

    authors: Edey KA,Allan E,Murdoch JB,Cooper S,Bryant A

    更新日期:2013-10-26 00:00:00

  • Aspirin for vascular dementia.

    abstract:BACKGROUND:For patients with a diagnosis of vascular dementia there is evidence that aspirin is widely prescribed - in one study, completed by geriatricians and psychiatrists in the UK, 80% of patients with cognitive impairment (with vascular risk factors) were prescribed aspirin. However, a number of queries remain un...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD001296

    authors: Williams PS,Rands G,Orrel M,Spector A

    更新日期:2000-01-01 00:00:00

  • Milnacipran for neuropathic pain and fibromyalgia in adults.

    abstract:BACKGROUND:Milnacipran is a serotonin-norepinephrine reuptake inhibitor (SNRI) that is sometimes used to treat chronic neuropathic pain and fibromyalgia. OBJECTIVES:To evaluate the analgesic efficacy and adverse effects of milnacipran in the management of chronic neuropathic pain or fibromyalgia. SEARCH METHODS:We se...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD008244.pub2

    authors: Derry S,Gill D,Phillips T,Moore RA

    更新日期:2012-03-14 00:00:00

  • Anti-cholinergic drugs for wheeze in children under the age of two years.

    abstract:BACKGROUND:Wheeze in infancy and early childhood is common and appears to be increasing though the magnitude of any increase is unclear. Most wheezing episodes in infancy are precipitated by respiratory viral infections. Treatment of very young children with wheeze remains controversial. Anti-cholinergics are often pre...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD001279

    authors: Everard ML,Bara A,Kurian M

    更新日期:2000-01-01 00:00:00

  • Carbamazepine for schizophrenia.

    abstract:BACKGROUND:Many people with schizophrenia do not achieve a satisfactory treatment response with just antipsychotic drug treatment and various adjunct medications are used to promote additional response. The antiepileptic carbamazepine is one such drug. OBJECTIVES:To evaluate the effects of carbamazepine and its deriva...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD001258.pub2

    authors: Leucht S,Kissling W,McGrath J,White P

    更新日期:2007-07-18 00:00:00

  • Empiric antibiotic coverage of atypical pathogens for community-acquired pneumonia in hospitalized adults.

    abstract:BACKGROUND:Community-acquired pneumonia (CAP) is caused by various pathogens, traditionally divided into 'typical' and 'atypical'. Initial antibiotic treatment of CAP is usually empirical, customarily covering both typical and atypical pathogens. To date, no sufficient evidence exists to support this broad coverage, wh...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD004418.pub4

    authors: Eliakim-Raz N,Robenshtok E,Shefet D,Gafter-Gvili A,Vidal L,Paul M,Leibovici L

    更新日期:2012-09-12 00:00:00

  • Interpersonal, cognitive analytic and other integrative therapies versus treatment as usual for depression.

    abstract::This is the protocol for a review and there is no abstract. The objectives are as follows: To examine the effectiveness and acceptability of all integrative therapies compared with treatment as usual/waiting list/attention placebo control conditions for acute depression.To examine the effectiveness and acceptability o...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章

    doi:10.1002/14651858.CD008703

    authors: Churchill R,Davies P,Caldwell D,Moore TH,Jones H,Lewis G,Hunot V

    更新日期:2010-01-01 00:00:00

  • Devices and pressure sources for administration of nasal continuous positive airway pressure (NCPAP) in preterm neonates.

    abstract:BACKGROUND:Nasal continuous positive airway pressure (NCPAP) is used to support preterm infants recently extubated, those experiencing significant apnoea of prematurity and those with respiratory distress soon after birth as an alternative to intubation and ventilation. This review will focus exclusively on identifying...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD002977

    authors: De Paoli AG,Davis PG,Faber B,Morley CJ

    更新日期:2002-01-01 00:00:00

  • Decongestants, antihistamines and nasal irrigation for acute sinusitis in children.

    abstract:BACKGROUND:The efficacy of decongestants, antihistamines and nasal irrigation in children with clinically diagnosed acute sinusitis has not been systematically evaluated. OBJECTIVES:To determine the efficacy of decongestants, antihistamines or nasal irrigation in improving symptoms of acute sinusitis in children. SEA...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD007909.pub4

    authors: Shaikh N,Wald ER

    更新日期:2014-10-27 00:00:00

  • Pharmacological treatment for Buerger's disease.

    abstract:BACKGROUND:Buerger's disease (thromboangiitis obliterans) is a non-atherosclerotic, segmental inflammatory pathology that most commonly affects the small and medium sized arteries, veins, and nerves in the upper and lower extremities. The aetiology is unknown, but involves hereditary susceptibility, tobacco exposure, i...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析

    doi:10.1002/14651858.CD011033.pub4

    authors: Cacione DG,Macedo CR,do Carmo Novaes F,Baptista-Silva JC

    更新日期:2020-05-04 00:00:00

  • Antibiotic treatment for Burkholderia cepacia complex in people with cystic fibrosis experiencing a pulmonary exacerbation.

    abstract:BACKGROUND:Chronic pulmonary infection is one of the hallmarks of lung disease in cystic fibrosis. Infections dominated by organisms of the Burkholderia cepacia complex, a group of at least 17 closely-related species of gram-negative bacteria, are particularly difficult to treat. These infections may be associated with...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD009529.pub2

    authors: Horsley A,Jones AM

    更新日期:2012-10-17 00:00:00

  • Antigen-specific active immunotherapy for ovarian cancer.

    abstract:BACKGROUND:Despite advances in chemotherapy, prognosis of ovarian cancer remains poor. Antigen-specific active immunotherapy aims to induce tumour-antigen-specific anti-tumour immune responses as an alternative treatment for ovarian cancer. OBJECTIVES:To assess the feasibility of antigen-specific active immunotherapy ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD007287.pub3

    authors: Leffers N,Daemen T,Helfrich W,Boezen HM,Cohlen BJ,Melief CJ,Nijman HW

    更新日期:2014-09-17 00:00:00

  • Once daily versus multiple daily dosing with intravenous aminoglycosides for cystic fibrosis.

    abstract:BACKGROUND:Patients with cystic fibrosis, who are chronically colonised with the organism Pseudomonas aeruginosa, often require repeated courses of intravenous aminoglycoside antibiotics for the management of pulmonary exacerbations. The properties of aminoglycosides suggest that they could be given in higher concentra...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD002009

    authors: Tan K,Bunn H

    更新日期:2000-01-01 00:00:00

  • Slow advancement of enteral feed volumes to prevent necrotising enterocolitis in very low birth weight infants.

    abstract:BACKGROUND:The major modifiable risk factors for necrotising enterocolitis (NEC) in very low birth weight (VLBW) infants relate to enteral feeding practices. Observational studies suggest that conservative feeding regimens that include slowly advancing enteral feed volumes reduce the risk of NEC. However, slow feed adv...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD001241.pub3

    authors: Morgan J,Young L,McGuire W

    更新日期:2011-03-16 00:00:00

  • Antimicrobial drugs for treating cholera.

    abstract:BACKGROUND:Cholera is an acute watery diarrhoea caused by infection with the bacterium Vibrio cholerae, which if severe can cause rapid dehydration and death. Effective management requires early diagnosis and rehydration using oral rehydration salts or intravenous fluids. In this review, we evaluate the additional bene...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD008625.pub2

    authors: Leibovici-Weissman Y,Neuberger A,Bitterman R,Sinclair D,Salam MA,Paul M

    更新日期:2014-06-19 00:00:00

  • Platinum-containing regimens for metastatic breast cancer.

    abstract:BACKGROUND:Studies have reported high tumour response rates for platinum-containing regimens in the treatment of women with metastatic breast cancer. Most of these studies were conducted prior to the 'intrinsic subtype' era, and did not specifically focus on metastatic triple-negative breast cancers (mTNBCs). OBJECTIV...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD003374.pub4

    authors: Egger SJ,Willson ML,Morgan J,Walker HS,Carrick S,Ghersi D,Wilcken N

    更新日期:2017-06-23 00:00:00

  • Reminder packaging for improving adherence to self-administered long-term medications.

    abstract:BACKGROUND:Current methods of improving medication adherence for health problems are mostly complex, labour-intensive, and not reliably effective. Medication 'reminder packaging' which incorporates a date or time for a medication to be taken in the packaging, can act as a reminder system to improve adherence. OBJECTIV...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD005025.pub2

    authors: Heneghan CJ,Glasziou P,Perera R

    更新日期:2006-01-25 00:00:00