Additional Bedtime H2-receptor Antagonist for the Control of Nocturnal Gastric Acid Breakthrough: A Systematic Review△_Chinese Journal of Evidence-Based Medicine

Authors：

PAN Tao ¹ ,  WANG Yiping ² , LIU Fucheng ¹ , WU Zongying ²

1. Department of Gastroenterology, The First People’s Hospital of Chengdu, Chengdu 610016, China 2. Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

WANG Yiping, Email: wyiping2002@yahoo.com

Keywords：

H2-receptor antagonist (H2RAs); Nocturnal gastric acid breakthrough (NAB); Systematic review; Randomized controlled trials

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Objectives　 To assess the effectiveness and safety of additional bedtime H2-receptor antagonists (H2RAs) in suppressing nocturnal gastric acid breakthrough (NAB).
Methods 　We identified eligible trials by searching The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMbase and CINAHL. We handsearched the data from the proceedings of correlated conferences, eight kinds of important Chinese journals and references of all included trials. All randomized controlled trials evaluating H2RAs for the control of NAB were eligible for inclusion. The systematic review was conducted using methods recommended by The Cochrane Collaboration.
Results 　Only two 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 impossible to conduct Meta-analysis. There was no consistent conclusion between the two included studies in evaluating H2RAs for the control of NAB.
Conclusion 　We can not conclude any implications for practice at this stage. Appropriately designed large-scale randomized controlled trials with long-term follow-up are needed to decide the effects of additional bedtime H2RAs in suppressing NAB.

Citation： PAN Tao,WANG Yiping,LIU Fucheng,WU Zongying. Additional Bedtime H2-receptor Antagonist for the Control of Nocturnal Gastric Acid Breakthrough: A Systematic Review△. Chinese Journal of Evidence-Based Medicine, 2006, 06(6): 416-420. doi: Copy

1.	Bate CM, Keeling PW, O’Morain C, et al. Comparison of omeprazole and cimetidine in reflux oesophagitis: symptomatic, endoscopic, and histological evaluations. Gut, 1990; 31(9): 968-972.
2.	Peghini PL, Katz PO, Bracy NA, et al. Nocturnal recovery of gastric acid secretion with twice-daily dosing of proton pump inhibitors. Am J Gastroenterol, 1998; 93(5): 763-767.
3.	Katz PO, Anderson C, Khoury R, et al. Gastro-oesophageal reflux associated with nocturnal gastric acid breakthrough on proton pump inhibitors. Aliment Pharmacol Ther, 1998; 12(12): 1231-1234.
4.	Fitzgerald RC, Omary MB, Triadafilopoulos G. Dynamic effects of acid on Barrett’s esophagus. An ex vivo proliferation and differentiation model. J Clin Invest, 1996; 98(9): 2120-2128.
5.	Ouatu-Lascar R, Fitzgerald RC, Triadafilopoulos G. Differentiation and proliferation in Barrett’s esophagus and the effects of acid suppression. Gastroenterology, 1999; 117(2): 327-335.
6.	Peters FT, Ganesh S, Kuipers EJ, et al. Endoscopic regression of Barrett’s oesophagus during omeprazole treatment; a randomised double blind study. Gut, 1999; 45(4): 489-494.
7.	Peghini PL, Katz PO, Castell DO. Ranitidine controls nocturnal gastric acid breakthrough on omeprazole: a controlled study in normal subjects. Gastroenterology, 1998; 115(6): 1335-1339.
8.	Katsube T, Adachi K, Kawamura A, et al. Helicobacter pylori infection influences nocturnal gastric acid breakthrough. Aliment Pharmacol Ther, 2000; 14(8): 1049-1056.
9.	Furuta T, Shirai N, Xiao F, et al. Effect of high-dose lansoprazole on intragastic pH in subjects who are homozygous extensive metabolizers of cytochrome P4502C19. Clin Pharmacol Ther, 2001; 70(5): 484-492.
10.	Fackler WK, Ours TM, Vaezi MF, et al. Long-term effect of H2RA therapy on nocturnal gastric acid breakthrough. Gastroenterology, 2002; 122(3): 625-632.
11.	Khoury RM, Katz PO, Hammod R, et al. Bedtime ranitidine does not eliminate the need for a second daily dose of omeprazole to suppress nocturnal gastric pH. Aliment Pharmacol Ther, 1999; 13(5): 675-678.
12.	Hongo M, Ohara S, Hirasawa Y, et al. Effect of lansoprazole on intragastric pH. Comparison between morning and evening dosing. Dig Dis Sci. 1992; 37(6): 882-890.
13.	Maton PN. Omeprazole. N Engl J Med. 1991; 324(14): 965-975.
14.	Fackler WK, Vaezi MF, Ours TM, et al. Nocturnal acid breakthrough and H2RAs: Another viewpoint. Am J Gastroenterol, 2000; 95(9): 2419.
15.	Ours TM, Fackler WK, Richter JE, et al. Nocturnal acid breakthrough: clinical significance and correlation with esophageal acid exposure. Am J Gastroenterol, 2003; 98(3): 545-550.

1. Bate CM, Keeling PW, O’Morain C, et al. Comparison of omeprazole and cimetidine in reflux oesophagitis: symptomatic, endoscopic, and histological evaluations. Gut, 1990; 31(9): 968-972.
2. Peghini PL, Katz PO, Bracy NA, et al. Nocturnal recovery of gastric acid secretion with twice-daily dosing of proton pump inhibitors. Am J Gastroenterol, 1998; 93(5): 763-767.
3. Katz PO, Anderson C, Khoury R, et al. Gastro-oesophageal reflux associated with nocturnal gastric acid breakthrough on proton pump inhibitors. Aliment Pharmacol Ther, 1998; 12(12): 1231-1234.
4. Fitzgerald RC, Omary MB, Triadafilopoulos G. Dynamic effects of acid on Barrett’s esophagus. An ex vivo proliferation and differentiation model. J Clin Invest, 1996; 98(9): 2120-2128.
5. Ouatu-Lascar R, Fitzgerald RC, Triadafilopoulos G. Differentiation and proliferation in Barrett’s esophagus and the effects of acid suppression. Gastroenterology, 1999; 117(2): 327-335.
6. Peters FT, Ganesh S, Kuipers EJ, et al. Endoscopic regression of Barrett’s oesophagus during omeprazole treatment; a randomised double blind study. Gut, 1999; 45(4): 489-494.
7. Peghini PL, Katz PO, Castell DO. Ranitidine controls nocturnal gastric acid breakthrough on omeprazole: a controlled study in normal subjects. Gastroenterology, 1998; 115(6): 1335-1339.
8. Katsube T, Adachi K, Kawamura A, et al. Helicobacter pylori infection influences nocturnal gastric acid breakthrough. Aliment Pharmacol Ther, 2000; 14(8): 1049-1056.
9. Furuta T, Shirai N, Xiao F, et al. Effect of high-dose lansoprazole on intragastic pH in subjects who are homozygous extensive metabolizers of cytochrome P4502C19. Clin Pharmacol Ther, 2001; 70(5): 484-492.
10. Fackler WK, Ours TM, Vaezi MF, et al. Long-term effect of H2RA therapy on nocturnal gastric acid breakthrough. Gastroenterology, 2002; 122(3): 625-632.
11. Khoury RM, Katz PO, Hammod R, et al. Bedtime ranitidine does not eliminate the need for a second daily dose of omeprazole to suppress nocturnal gastric pH. Aliment Pharmacol Ther, 1999; 13(5): 675-678.
12. Hongo M, Ohara S, Hirasawa Y, et al. Effect of lansoprazole on intragastric pH. Comparison between morning and evening dosing. Dig Dis Sci. 1992; 37(6): 882-890.
13. Maton PN. Omeprazole. N Engl J Med. 1991; 324(14): 965-975.
14. Fackler WK, Vaezi MF, Ours TM, et al. Nocturnal acid breakthrough and H2RAs: Another viewpoint. Am J Gastroenterol, 2000; 95(9): 2419.
15. Ours TM, Fackler WK, Richter JE, et al. Nocturnal acid breakthrough: clinical significance and correlation with esophageal acid exposure. Am J Gastroenterol, 2003; 98(3): 545-550.

Chinese Journal of Evidence-Based Medicine

Additional Bedtime H2-receptor Antagonist for the Control of Nocturnal Gastric Acid Breakthrough: A Systematic Review△

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