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Additional bedtime H2-receptor antagonist for the control of nocturnal gastric acid breakthroughTao Pan, Yiping Wang, Zheng Guo, Qiong Wang
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This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2008 Issue 3, Copyright © 2008 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
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October 18. 2004 AbstractBackgroundNocturnal gastric acid breakthrough(NAB) is defined as intragastric pH<4 for more than one continuous hour overnight. Adding H2-receptor antagonists (H2RAs)at bedtime to high-dose proton pump inhibitors is likely to enhance nocturnal gastric pH control and decrease nocturnal gastric acid breakthrough. ObjectivesTo assess the effectiveness of additional bedtime H2-receptor antagonists in suppressing nocturnal gastric acid breakthrough and the incidence of adverse effects. Search strategyWe identified eligible trials by searching The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 3, 2003), MEDLINE (1966-July 2003), EMBASE (1980-July 2003) and CINAHL (1982-July 2003). We re-ran the search on CENTRAL (The Cochrane Library Issue 2, 2004), and in MEDLINE, EMBASE and CINAHL in June 2004, July 2005 and August 2006. Selection criteriaAll randomized controlled trials evaluating H2-receptor antagonists for the control of nocturnal gastric acid breakthrough were eligible for inclusion. Data collection and analysisWe had intended to analyse such outcomes for the presence of skew, but the studies included were too limited to permit this. Main resultsTwo randomized crossover studies including 32 participants met the inclusion criteria. Because the design, dosage and duration of the treatment were different between the studies, it was not possible to conduct meta-analysis. There is no consistent conclusion between the two included studies in evaluating H2RAs for the control of NAB. Authors' conclusionsWe can conclude no implications for practice at this stage. Appropriately designed large-scale randomized controlled trials with long-term follow-up are needed to determine the effects of additional bedtime H2RAs in suppressing nocturnal gastric acid breakthrough. |