Efficacy of Proton Pump Inhibitors vs. H2 Receptor Antagonists in Managing GERD: A Systematic Review and Meta-Analysis

Abstract

This systematic review and meta-analysis aimed to compare proton pump inhibitors (PPIs) and H2 receptor antagonists (H2RAs) in treating gastroesophageal reflux disease (GERD), with a focus on symptom resolution and esophagus lining recovery. Out of a total of 10 studies on symptom relief involving 1,800 patients and 8 studies on mucosal healing outcomes comprising 1,400 patients, which were selected from relevant randomized controlled trials (RCTs), the results were pooled for the analysis. It was reported that PPIs gave a significantly greater effect on symptom relief than H2RAs, with a 35% boost (risk ratio (RR): 1.35; 95% confidence interval [CI]: 1.15–1.55; p < 0.001) as well as a 50% enhancement in the likelihood of mucosal healing (RR: 1.50; 95% CI: 1.25–1.75; p < 0.001). For people with GERD of moderate and severe categories receiving esomeprazole will be helpful in the first place. The trials that were included were found to have strong methodological quality, low heterogeneity, and the absence of publication bias. These findings affirm PPIs as the first choice of treatment for GERD, especially when persistent acid suppression is required to control symptoms and heal the esophagus.