TABLE 1.

a PPI treatment of ECP related to GERD
Referenc e	Method s Score	Interventio n	Study Design	Study Size (n)	Mean Age Years	F/M	Duratio n	Outcome Measures	Patient characteristics	Results	Safety Analysis
14 Fass et al.	5	Omeprazole 40 mg a.m. and 20 mg p.m. or Placebo	Double-blind, placebo controlled crossover	39	60	1/38	7 days then crossov er for 7 days	CPF and CPS on a VAS Composite chest pain score severity x frequency/wk	+ve and −ve EGD and/ or positive pH metry, no manometry, −ve cardiac angiogram or – ve cardiac stress tests	Response to Omeprazole in GERD+ ve vs GERD −ve Resolution: 52% vs 4%. > 50% improvement:26% vs 18% <50% improvement: 18% vs 27% No change:4% vs 51% Response to Placebo in GERD+ vs GERD-=23% vs 7%	1 diarrhea and 1 abdominal pain
19 Achem et al.	5	Omeprazole 20 mg BID or Placebo	Double-blind, placebo controlled	36	49	23/1 1	8 weeks	CPF and CPS (0– 10); global chest pain rating (better, same and worse)	−ve EGD (90%), +ve pH metry (100%), +ve/−ve manometry, −ve coronary angiography, or −ve stress thallium test	CPF: decreased 39% (omeprazole) and 10% (placebo), p<0.006 CPS: decreased 41% (omeprazole) and 15% (placebo), p<0.032 global severity: Omeprazole better 81%, same 6%, worse 13% vs placebo 6%, 72%, and 22% respectively (p<0.001)	Mild symptoms of headaches, abdominal pain, diarrhea, nausea and rash
20 Pandak et al.	5	Omeprazole 40 mg BID or Placebo	Double-blind, placebo controlled crossover	42	48	24/1 8	14 days then crossov er for 14 days	CPF and CPS improvement in 2 points from baseline VAS(0–10) and > 50% response	+ve and −ve EGD and/ or +ve pH metry, −ve stress test	Overall Response: 71% (Omeprazole) and 18% (placebo) Responders: GERD +ve: 95% omeprazole v 10% placebo GERD − ve:39% omeprazole	Not performed
21Xia et al	2	Lansoprazole 30 mg/day or placebo	Single blind, placebo controlled	68	58	26/42	4 weeks	CPF and CPS= severity x frequency/wk	−ve EGD, +ve and −ve pH metry, no manometry, −ve coronary angiography	Overall improvement 53% (Lansoprazole) vs 34% (placebo), p<0.127 Responders: GERD +ve: 92% (Lansoprazole) vs 33% (placebo), p<0.001 GERD −ve: 33% (Lansoprazole) vs 35% (Placebo), p=NS	Not reported
22Bautista et al.	4	Lansoprazole 60 mg am and 30 mg pm or placebo	Double blind, placebo-controlled crossover	40	54	9/31	7 days then crossover for 7days	CPF and CPS VAS Composite chest pain score severity x frequency/wk	+ve EGD and / or pH metry −ve coronary angiogram or – ve cardiac stress test	Lanzoprazole Response GERD+ ve vs GERD −ve Resolution: 39% vs 0%. > 50% improvement:39% vs 9% <50% improvement: 5% vs 50% No change: 17% vs 41% Lansoprazole vs placebo GERD + ve 78% vs 22%, p=0.01 Gerd −ve: 9% vs 36%, p=0.7	Not reported
23Dickman et al.	4	Rabeprazole 20 mg/day or placebo	Double blind, placebo controlled, crossover	35	56	12/23	7 days	CPF and CPS improvement > 50%	+ve and −ve EGD, and/ or pH metry, no manometry, −ve coronary angiogram or – ve stress test	Rabeprazole vs Placebo: > 50% improvement GERD+ve: 75% vs 11% GERD−ve: 19% vs 21%	Not reported
24Kim et al.	0	Rabeprazole 20 mg BID	Open label trial, First week vs second week	42	54	17/25	2 weeks	CPF and CPS = >50% improvement Composite score= severity x frequency/wk	+ve and −ve EGD and/ or +ve pH metry, no manometry, −ve stress test	Overall response, week 2: 81% (Rabeprazole) and 27% (placebo) GERD+ ve vs GERD −ve Resolution: 45% vs 12%. > 50% improvement:38% vs 14% <50% improvement: 6% vs 28% No change:11% vs 46% Week 1: GERD +ve vs GERD −ve = 8.5% vs 6.2%, p=NS	Not performed

b Quality assessment of PPIs
Reference	Randomization	Blinding	Statement on Withdrawals	Total Score
Fass et al. (14)	2	2	1	5
Achem et al. (19)	2	2	1	5
Pandak et.al. (20)	2	2	1	5
Xia et al. (21)	1	0	1	2
Bautista et al. (22)	2	2	0	4
Dickman et al. (23)	2	2	0	4
Kim et al. (24)	0	0	0	0

CPF: Chest Pain Frequency CPS: Chest Pain Score (severity) VAS: Visual Analog Scale GERD: Gastroesophageal Reflux Disease

NS: Not Significant