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Iskedjian M, Einarson TR. Meta-Analyses of Cisapride, Omeprazole and Ranitidine in the Treatment of GORD: Implications for Treating Patient Subgroups. Clin Drug Investig. 1998;16(1):9-18doi: 10.2165/00044011-199816010-00002.
Iskedjian, M., & Einarson, T. R. (1998). Meta-Analyses of Cisapride, Omeprazole and Ranitidine in the Treatment of GORD: Implications for Treating Patient Subgroups. Clinical drug investigation, 16(1), 9-18. https://doi.org/10.2165/00044011-199816010-00002
Iskedjian, M, and Einarson, T R. "Meta-Analyses of Cisapride, Omeprazole and Ranitidine in the Treatment of GORD: Implications for Treating Patient Subgroups." Clinical drug investigation vol. 16,1 (1998): 9-18. doi: https://doi.org/10.2165/00044011-199816010-00002
Iskedjian M, Einarson TR. Meta-Analyses of Cisapride, Omeprazole and Ranitidine in the Treatment of GORD: Implications for Treating Patient Subgroups. Clin Drug Investig. 1998;16(1):9-18. doi: 10.2165/00044011-199816010-00002. PMID: 18370513.
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Clin Drug Investig. 1998;16(1):9-18. doi: 10.2165/00044011-199816010-00002.

Meta-Analyses of Cisapride, Omeprazole and Ranitidine in the Treatment of GORD: Implications for Treating Patient Subgroups.

Clinical drug investigation

M Iskedjian, T R Einarson

Affiliations

  1. PharmIdeas Consulting Services, Hamilton, Ontario, Canada.

PMID: 18370513 DOI: 10.2165/00044011-199816010-00002

Abstract

OBJECTIVE: Meta-analyses of efficacy results reported in trials of the pharmacological treatment of gastro-oesophageal reflux disease (GORD) with cisapride, omeprazole or ranitidine were performed using randomised, double-blind studies identified by a Medline search covering the years 1984 to 1995.

RESULTS: The overall order of efficacy following 12 weeks of acute treatment was omeprazole 40 mg/day (95% cured) > ranitidine 600 mg/day (81% cured) > cisapride 40 mg/day or ranitidine 300 mg/day (approximately 60% cured). However, important differences emerged regarding efficacy in mild versus severe GORD, and in the frequency of relapse. In mild GORD, the cure rate with cisapride 40 mg/day was greater than the cure rate with ranitidine 300 mg/day (56 vs 38%, respectively), and the cure rate with cisapride 80 mg/day was similar to the cure rate with omeprazole 20 mg/day (82 vs 75%, respectively). In severe GORD, the cure rate with cisapride 80 mg/day was half that of omeprazole 20 mg/day (43 vs 87%, respectively) and comparable with that of ranitidine 300 mg/day (50%). Among patients treated acutely with omeprazole, 6-month relapse rates were 17% with omeprazole 20 mg/day maintenance therapy, but 76 to 80% without maintenance therapy. Among patients treated acutely with cisapride, 6-month relapse rates were 33% with 20 mg/day maintenance therapy and only 40% without maintenance therapy, which compare favourably with those following 6 months' maintenance therapy with ranitidine 300 mg/day (49%).

CONCLUSION: These results indicate that omeprazole is clearly the treatment of choice for severe GORD, suggest that cisapride may be the treatment of choice for mild GORD, and indicate that either of these two treatments is superior to ranitidine for the prevention of relapse. Further comparative clinical studies are needed, designed specifically to delineate the most appropriate drug therapy for various subgroups of GORD patients.

References

  1. Lancet. 1988 Jul 23;2(8604):229 - PubMed
  2. Hepatogastroenterology. 1990 Aug;37(4):403-7 - PubMed
  3. Scand J Gastroenterol. 1988 Jun;23(5):625-32 - PubMed
  4. Hepatogastroenterology. 1983 Jun;30(3):96-8 - PubMed
  5. Aliment Pharmacol Ther. 1992 Oct;6(5):597-607 - PubMed
  6. Scand J Gastroenterol. 1991 Mar;26(3):248-56 - PubMed
  7. Gut. 1990 May;31(5):509-13 - PubMed
  8. Drugs. 1995 May;49(5):695-710 - PubMed
  9. Control Clin Trials. 1986 Sep;7(3):177-88 - PubMed
  10. Gut. 1988 May;29(5):675-81 - PubMed
  11. Nature. 1981 Mar 12;290(5802):159-61 - PubMed
  12. Dig Dis Sci. 1988 May;33(5):523-9 - PubMed
  13. Aliment Pharmacol Ther. 1993 Oct;7(5):501-7 - PubMed
  14. Arch Intern Med. 1996 Mar 11;156(5):477-84 - PubMed
  15. J Clin Gastroenterol. 1988 Dec;10(6):614-8 - PubMed
  16. Scand J Gastroenterol. 1992;27(3):175-83 - PubMed
  17. N Engl J Med. 1992 Mar 19;326(12):825-7 - PubMed
  18. Aliment Pharmacol Ther. 1995;9 Suppl 1:3-7 - PubMed
  19. Drugs Exp Clin Res. 1985;11(10):687-92 - PubMed
  20. Gastroenterol Clin Biol. 1989 May;13(5):457-62 - PubMed
  21. Dig Dis Sci. 1990 May;35(5):649-55 - PubMed
  22. Hepatogastroenterology. 1986 Oct;33(5):208-13 - PubMed
  23. Am J Med. 1987 Sep 28;83(3B):43-7 - PubMed
  24. Br Med J (Clin Res Ed). 1988 Jan 9;296(6615):89-92 - PubMed
  25. Gut. 1993 Aug;34(8):1025-31 - PubMed
  26. Gastrointest Endosc Clin N Am. 1994 Oct;4(4):677-98 - PubMed
  27. Drug Intell Clin Pharm. 1988 Oct;22(10):813-24 - PubMed
  28. Gut. 1991 Nov;32(11):1280-5 - PubMed
  29. Am J Gastroenterol. 1995 Mar;90(3):423-30 - PubMed
  30. J Epidemiol Community Health. 1991 Jun;45(2):89-92 - PubMed
  31. Gastroenterology. 1986 Nov;91(5):1198-205 - PubMed
  32. Lancet. 1987 Feb 14;1(8529):349-51 - PubMed
  33. Scand J Gastroenterol. 1993 Mar;28(3):224-8 - PubMed
  34. Scand J Gastroenterol Suppl. 1989;166:76-82; discussion 94 - PubMed
  35. Gastroenterology. 1992 Jan;102(1):109-18 - PubMed
  36. Am J Med. 1991 Aug 8;91(2A):119S-122S - PubMed
  37. Gastroenterology. 1994 Nov;107(5):1305-11 - PubMed
  38. Med J Aust. 1983 Nov 26;2(11):558-61 - PubMed
  39. Dig Dis Sci. 1993 Mar;38(3):551-60 - PubMed
  40. Gut. 1990 Sep;31(9):968-72 - PubMed
  41. Gut. 1994 May;35(5):590-8 - PubMed
  42. Gastroenterology. 1988 Oct;95(4):903-12 - PubMed
  43. Hepatogastroenterology. 1988 Jun;35(3):125-7 - PubMed
  44. Ann Gastroenterol Hepatol (Paris). 1993 Jun-Sep;29(4):213-8 - PubMed
  45. J Clin Gastroenterol. 1992 Oct;15(3):192-8 - PubMed
  46. Digestion. 1990;45(2):109-14 - PubMed
  47. Digestion. 1984;29(2):119-23 - PubMed
  48. Br J Clin Pract. 1994 Jan-Feb;48(1):10-4 - PubMed
  49. Arch Surg. 1996 Oct;131(10):1021-3 - PubMed
  50. Gut. 1983 Oct;24(10):921-4 - PubMed
  51. Aliment Pharmacol Ther. 1993 Aug;7(4):409-15 - PubMed
  52. Hepatogastroenterology. 1987 Aug;34(4):155-9 - PubMed
  53. J Clin Gastroenterol. 1984 Feb;6(1):9-15 - PubMed
  54. Scand J Gastroenterol. 1986 Mar;21(2):175-80 - PubMed
  55. Br J Clin Pract Suppl. 1989 Feb;66:59-60; discussion 61-4 - PubMed
  56. Aliment Pharmacol Ther. 1993 Apr;7(2):181-90 - PubMed
  57. Aliment Pharmacol Ther. 1993 Dec;7(6):635-41 - PubMed
  58. Am J Hosp Pharm. 1985 Sep;42(9):1957-64 - PubMed
  59. Am J Gastroenterol. 1993 Apr;88(4):520-4 - PubMed

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