A systematic review of proton-pump inhibitor therapy for laryngopharyngeal reflux

August 21, 2013
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Abstract

The author performed a MEDLINE literature search to identify and evaluate all randomized, placebo-controlled trials of the treatment of laryngopharyngeal reflux (LPR) with an oral proton-pump inhibitor (PPI) that have been published since 1966. Eight such trials that included a total of 358 patients were identified. These eight studies contained seven different definitions of LPR. Validity scores (maximum: 9) ranged from 5 to 9 (mean: 7.5). One study investigated low-dose once-daily therapy, two studies investigated low-dose twice-daily therapy, and five studies investigated high-dose twice-daily therapy. Outcomes measures were not consistent among studies, and most studies used unvalidated outcomes measures. Only two studies found that a PPI was significantly better than placebo-one in the low-dose twice-daily group and one in the high-dose twice-daily group. The author concludes that the current body of literature is insufficient to draw reliable conclusions about the efficacy of PPI therapy for the treatment of LPR.

Introduction

Laryngopharyngeal reflux (LPR) is the retrograde flow of gastric contents into the pharynx and larynx. This causes the gastric contents, including acid and pepsin, to come into contact with the laryngeal and pharyngeal mucosa, which can cause injury and inflammation. It has been estimated that patients with LPR make up 4 to 10% of all patients seen in otolaryngology clinics.1

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