The Effects of Baclofen for the Treatment of Gastroesophageal Reflux Disease: A Meta-Analysis of Randomized Controlled Trials

Shujie Li,Shengying Shi,Feng Chen,Jingming Lin

doi:10.1155/2014/307805

Abstract

Objectives. Baclofen can relieve gastroesophageal reflux-related symptoms in healthy subjects and gastroesophageal reflux disease (GERD) patients by reducing the incidence of transient lower esophageal sphincter relaxation. This meta-analysis aimed to evaluate the efficacy and safety of baclofen for the treatment of GERD. Methods. We systematically searched randomized controlled trials published prior to November 2013 from PubMed, Medline, Embase, ScienceDirect, ClinicalTrials.gov, and the Cochrane Central Register of Randomized Controlled Trials. We performed a meta-analysis of all eligible trials. Results. Nine studies were identified with a total of 283 GERD patients and healthy subjects. Comparative analysis provided high quality data supporting the ability of baclofen to promote a short-term decrease in the number of reflux episodes per patient, the average length of reflux episodes, and the incidence of transient lower esophageal sphincter relaxation. No serious adverse events or death events were reported, and there were no significant differences in the overall adverse events between baclofen and placebo. All reported side effects of baclofen were of mild-to-moderate intensity, and the drug was well tolerated. Conclusion. Abundant evidence suggests that baclofen may be a useful approach for the treatment of GERD patients; however, a larger well-designed research study would further confirm this recommendation.

Highlights

Gastroesophageal reflux disease (GERD), which is defined as a disorder caused by the reflux of gastric contents into the esophagus, has long been a prominent concern worldwide
Endoscopic or microscopic evidence of damage to the esophageal mucosa can be observed for GERD patients, though the body undergoes initial attempts to protect itself by tightening the gastroesophageal junction, a muscular complex consisting of the lower esophageal sphincter, the rural diaphragm, and the gastric sling [5, 6]
We identified 121 articles through database searching after application of our criteria

Summary

Introduction

Gastroesophageal reflux disease (GERD), which is defined as a disorder caused by the reflux of gastric contents into the esophagus, has long been a prominent concern worldwide. Recent evidence suggests that transient lower esophageal sphincter relaxation (TLESR) might be the primary cause of reflux episodes in patients with GERD [7, 8]. Proton pump inhibitors [9] and histamine type 2 receptor antagonists [10] are first-line treatment for patients with GERD. Both methods depend primarily on the inhibition of acid secretion. Despite their high performance in symptom resolution and esophageal mucosal healing, clinical failure has become a common dilemma for patients with GERD [11].

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Conclusion