PMID- 15521002
OWN - NLM
STAT- MEDLINE
DCOM- 20041203
LR  - 20240109
IS  - 0016-5085 (Print)
IS  - 0016-5085 (Linking)
VI  - 127
IP  - 5
DP  - 2004 Nov
TI  - The efficacy of proton pump inhibitors in nonulcer dyspepsia: a systematic review 
      and economic analysis.
PG  - 1329-37
AB  - BACKGROUND AND AIMS: The evidence that proton pump inhibitor (PPI) therapy 
      affects symptoms of nonulcer dyspepsia is conflicting. We conducted a systematic 
      review to evaluate whether PPI therapy had any effect in nonulcer dyspepsia and 
      constructed a health economic model to assess the cost-effectiveness of this 
      approach. METHODS: Electronic searches were performed using the Cochrane 
      Controlled Trials Register, MEDLINE, EMBASE, CINAHL, and SIGLE until September 
      2002. Dyspepsia outcomes were dichotomized into cured/improved versus same/worse. 
      Results were incorporated into a Markov model comparing health service costs and 
      benefits of PPI with antacid therapy over 1 year. RESULTS: Eight trials were 
      identified that compared PPI therapy with placebo in 3293 patients. The relative 
      risk of remaining dyspeptic with PPI therapy versus placebo was .86 (95% 
      confidence interval, .78-.95; P = .003, random-effects model) with a number 
      needed to treat of 9 (95% confidence interval, 5-25). There was statistically 
      significant heterogeneity between trials (heterogeneity chi(2) = 30.05; df = 7; P 
      < .001). The PPI strategy would cost an extra US dollar 278/month free from 
      dyspepsia if the drug cost US dollar 90/month. If a generic price of US dollar 
      19.99 is used, then a PPI strategy costs an extra US dollar 57/month free from 
      dyspepsia. A third-party payer would be 95% certain that PPI therapy would be 
      cost-effective, provided they were willing to pay US dollar 94/month free from 
      dyspepsia. CONCLUSIONS: PPI therapy may be a cost-effective therapy in nonulcer 
      dyspepsia, provided generic prices are used.
FAU - Moayyedi, Paul
AU  - Moayyedi P
AD  - Gastroenterology Division, McMaster University, Hamilton, Ontario, Canada. 
      moayyep@mcmaster.ca
FAU - Delaney, Brendan C
AU  - Delaney BC
FAU - Vakil, Nimish
AU  - Vakil N
FAU - Forman, David
AU  - Forman D
FAU - Talley, Nicholas J
AU  - Talley NJ
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PT  - Systematic Review
PL  - United States
TA  - Gastroenterology
JT  - Gastroenterology
JID - 0374630
RN  - 0 (Placebos)
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
CIN - Gastroenterology. 2005 Mar;128(3):805; author reply 805-6. PMID: 15765429
CIN - ACP J Club. 2005 May-Jun;142(3):74. PMID: 15862073
MH  - Clinical Trials as Topic
MH  - Costs and Cost Analysis
MH  - Dyspepsia/*drug therapy/*economics
MH  - Humans
MH  - Placebos
MH  - Probability
MH  - *Proton Pump Inhibitors
RF  - 41
EDAT- 2004/11/03 09:00
MHDA- 2004/12/16 09:00
CRDT- 2004/11/03 09:00
PHST- 2004/11/03 09:00 [pubmed]
PHST- 2004/12/16 09:00 [medline]
PHST- 2004/11/03 09:00 [entrez]
AID - S0016508504014349 [pii]
AID - 10.1053/j.gastro.2004.08.026 [doi]
PST - ppublish
SO  - Gastroenterology. 2004 Nov;127(5):1329-37. doi: 10.1053/j.gastro.2004.08.026.