CLINICAL GASTROENTEROLOGY AND HEPATOLOGY 2007;5:178 –185 ffects of Proton-Pump Inhibitors on Functional Dyspepsia: Meta-analysis of Randomized Placebo-Controlled Trials

ackground & Aims: The aim of this study was to ssess systematically the efficacy of proton pump inhibtors (PPIs) in the treatment of functional dyspepsia ompared with placebo and to determine if any differnce in the response exists between symptom subgroups f functional dyspepsia. Methods: A literature search as performed through September 2005 in PubMed, Medine, Embase, CINAHL, and Cochrane databases to include andomized, double-blind, placebo-controlled trials evaluting the efficacy of PPIs for the treatment of functional yspepsia. Relative risk (RR) and relative risk reduction RRR) and 95% confidence intervals (CI) were calculated nder a random-effects model. Results: Seven studies ith a total of 3725 patients were identified. PPIs were ound to be more effective than placebo for reducing ymptoms in patients with functional dyspepsia (RRR, 0.3%; 95% CI, 2.7%–17.3%). The estimated number eeded to treat is 14.6 (95% CI, 8.7–57.1). When stratified nalyses were performed, a significant difference in the fficacy was observed only in patients with ulcer-like RRR, 12.8%; 95% CI, 7.2%–18.1%) and reflux-like dyspepia (RRR, 19.7%; 95% CI, 1.8%–34.3%), but not in those ith dysmotility-like (RRR, 5.1%; 95% CI, 10.9% to 8.7%) and unspecified dyspepsia (RRR, 8.0%; 95% CI, 23.7% to 5.6%). The effect of H pylori on the efficacy of PIs remains unclear. Significant heterogeneity among tudies was found for the overall analysis, dysmotilityike dyspepsia, H pylori–negative subgroup, and different ose subgroups. Conclusions: PPIs are more effective han placebo for the management of patients with ulcerike and reflux-like functional dyspepsia.