Proton Pump Inhibitor Therapy for the Treatment of Laryngopharyngeal Reflux

GOALS: To compare the treatment effect of proton pump inhibitor (PPI) therapy and placebo for patients with laryngopharyngeal reflux (LPR). STUDY: PubMed, Cochrane Library, and EMBASE were searched from the date of conception to August 2014. Randomized controlled clinical trials (RCTs) were included in this meta-analysis if they compared the treatment response of PPI therapy and placebo among patients with LPR. The risk difference, the standard mean difference (SMD), and their corresponding 95% confidence intervals (CIs) were calculated for the endpoints evaluated. RESULTS: Fourteen eligible RCTs with 771 participants were identified and analyzed in this meta-analysis. By pooling all eligible data, we found that patients treated with PPI therapy had a significantly higher response rate than those who received placebo (risk difference=0.15; 95% CI, 0.01-0.30). Compared with placebo, PPI therapy could also improve the total reflux symptom index significantly (SMD=1.65; 95% CI, 0.15-3.14), but results of the reflux symptom index varied for specific symptoms. However, PPI therapy did not show any advantage over placebo in the improvement of the reflux finding score (SMD=0.62; 95% CI, -0.96-2.19). CONCLUSIONS: In this meta-analysis of 14 eligible RCTs, we found that in patients with LPR, PPI therapy could improve reflux symptoms significantly compared with placebo.