Table 3.

Efficacy of PPIs and H₂RAs in Empirical Treatment of GERD and in ENRD; Individual Studies and Pooled Results

				Outcome
		Intervention		Heartburn Free, n
Type Reflux Disease Comparison	First Author, Year of Publication	1st Arm	2nd Arm	1st Arm	2nd Arm	RR (95% CI)	NNTB
GERD
PPI – placebo	Hatlebakk, 199951	Omeprazole 20 mg/d	Placebo	122/161	48/159	0.35 (0.26 to 0.46)	2.2
H2RA – placebo	Hallerback, 199846	Ranitidine 150 mg bid	Placebo	86/210	68/213	0.87 (0.75 to 1.00)	11.1
	Rush, 199544	Ranitidine 150 mg bid	Placebo	193/301	136/289	0.68 (0.56 to 0.82)	7.4
Pooled result of H2RA versus placebo trials				279/511	204/502	0.77 (0.60 to 0.99)
PPI – H2RA	Armstrong, 200141	Pantoprazole 40 mg/d	Nizatidine 150 mg bid	93/106	59/102	0.29 (0.17 to 0.51)	3.3
	Bardhan, 199945	Omeprazole 20 mg/d	Ranitidine 150 mg bid	122/221	60/229	0.29 (0.19 to 0.43)	3.4
		Omeprazole 10 mg/d	Ranitidine 150 mg bid	91/227	60/229	0.53 (0.36 to 0.79)	7.2
	Bate, 199742	Omeprazole 20 mg/d	Cimetidine 400 mg qid	74/112	34/109	0.23 (0.13 to 0.41)	2.9
	Venables, 199743	Omeprazole 20 mg/d	Ranitidine 150 mg bid	200/330	131/326	0.44 (0.32 to 0.60)	4.9
		Omeprazole 10 mg/d	Ranitidine 150 mg bid	167/338	131/326	0.69 (0.51 to 0.94)	10.8
Pooled result of PPI (low dose) versus H2RA trials				258/565	191/555	0.83 (0.75 to 0.91)
Pooled result of PPI (standard dose) versus H2RA trials				489/769	284/766	0.55 (0.44 to 0.68)
ENRD
PPI – placebo	Bate, 199652	Omeprazole 20 mg/d	Placebo	50/98	18/111	0.58 (0.47 to 0.73)	2.9
	Carlsson, 199847	Omeprazole 20 mg/d	Placebo	25/87	17/88	0.88 (0.75 to 1.04)	10.6
		Omeprazole 10 mg/d	Placebo	27/86	17/88	0.85 (0.71 to 1.01)	8.3
	Lind, 199749	Omeprazole 20 mg/d	Placebo	125/205	25/105	0.51 (0.42 to 0.63)	2.7
		Omeprazole 10 mg/d	Placebo	98/199	25/105	0.67 (0.56 to 0.79)	3.9
	Miner, 200253	Rabeprazole 20 mg/d	Placebo	19/67	2/68	0.74 (0.63 to 0.86)	3.9
		Rabeprazole 10 mg/d	Placebo	19/64	2/68	0.72 (0.61 to 0.85)	3.7
	Richter, 200054	Omeprazole 20 mg/d	Placebo	57/118	6/123	0.54 (0.45 to 0.65)	2.3
		Omeprazole 10 mg/d	Placebo	32/118	6/123	0.77 (0.68 to 0.86)	4.5
Pooled result of PPI (low dose) versus placebo trials				176/467	50/384	0.75 (0.69 to 0.82)
Pooled result of PPI (standard dose) versus placebo trials				276/575	68/495	0.64 (0.52 to 0.79)
H2RA – placebo	Riemann, 199148	Cimetidine 200 mg qid	Placebo	22/60	12/65	0.78 (0.62 to 0.97)	5.5
PPI – H2RA	Armstrong, 200141	Pantoprazole 40 mg/d	Nizatidine 150 mg bid	19/36	18/42	0.83 (0.54 to 1.27)	10.1
	Bate, 199742	Omeprazole 20 mg/d	Cimetidine 400 mg qid	27/49	17/54	0.66 (0.46 to 0.94)	4.2
	Venables, 199743	Omeprazole 20 mg/d	Ranitidine 150 mg bid	120/229	94/212	0.86 (0.71 to 1.03)	12.4
		Omeprazole 10 mg/d	Ranitidine 150 mg bid	118/236	94/212	0.90 (0.75 to 1.07)	17.7
Pooled result of PPI (standard dose) versus H2RA trials				166/314	129/308	0.81 (0.70 to 0.95)

RR, relative risk; CI, confidence interval; RR < 1 indicating outcome in favor of first treatment arm; NNT_B, number needed to treat for benefit; bid, twice daily; qid, four times daily; relative risks are plotted for each individual trial (black square) along with its 95% confidence interval (horizontal line); meta-analysis of results (and 95% confidence interval) is represented by black diamond; H₂RA, histamine-2 receptor antagonist; PPI, proton pump inhibitor.