Efficacy and Safety of Esomeprazole for the Treatment of Reflux Symptoms in Patients with Gastroesophageal Reflux Disease: A Systematic Review and Meta-Analysis
,
Abstract
Background: We investigated the efficacy of esomeprazole for the treatment of gastroesophageal reflux disease (GERD) in a meta-analysis of clinical trials results.
Methods: Medline, Embase, PubMed and Web of Science databases were systematically searched for suitable studies, and double-blind, randomized controlled trials (RCTs) were involved. A meta-analysis of RCTs was performed to analyze the efficacy of esomeprazole on clinical outcomes that associated with the severity of GERD.
Results: A total of 8 clinical trials were selected in our meta-analysis (N=4495, patients with GERD). Esomeprazole treatment yielded a significant improvement in clinical signs and symptoms of GERD compared to placebo group. Funnel plot and Egger test showed there was no significant bias in the publication. Cochrane collaboration tool and Jadad scale were used to indicate that all 8 RCTs were of high quality. The results of Galbraith radial plot showed that no study was the major source of heterogeneity. Esomeprazole treatment significantly decreased the relapse rates more than that of placebo group (RR = 0.729; 95% CI: 0.670 to 0.794; P<0.001). It seems to be lower rates of heartburn (RR = 0.747; 95%CI: 0.665-0.839; P <0.001) and epigastric pain (RR = 0.795; 95%CI: 0.679-0.932; P =0.005) in esomeprazole-treated group compared with the placebo group. Moreover, serious adverse events was less likely to happen after esomeprazole therapy (RR = 1.406, 95% CI: 1.030-1.918; P =0.032).
Conclusion: Compared with the control group, esomeprazole is a promising therapeutic agent that improves the management of patients with GERD.
1. Clarke JO, Fernandez-Becker NQ, Regalia KA, Triadafilopoulos G (2018). Baclofen and gastroesophageal reflux disease: seeing the forest through the trees. Clin Transl Gastroenterol, 9 (3):137.
2. Kellerman R, Kintanar T (2017). Gastroesophageal Reflux Disease. Prim Care, 44 (4):561-573.
3. Barnhart DC (2016). Gastroesophageal reflux disease in children. Semin Pediatr Surg, 25 (4):212-8.
4. Maqbool A, Ryan MJ (2018). Gastroesophageal Reflux Disease and Aerodigestive Disorders. Curr Probl Pediatr Adolesc Health Care, 48 (3):85-98.
5. Patti MG (2016). An Evidence-Based Approach to the Treatment of Gastroesophageal Reflux Disease. JAMA Surg, 151 (1):73-8.
6. Mikami DJ, Murayama KM (2015). Physiology and pathogenesis of gastroesophageal reflux disease. Surg Clin North Am, 95 (3):515-25.
7. Quach DT, Nguyen TT, Hiyama T (2018). Abnormal Gastroesophageal Flap Valve Is Associated With High Gastresophageal Reflux Disease Questionnaire Score and the Severity of Gastroesophageal Reflux Disease in Vietnamese Patients With Upper Gastrointestinal Symptoms. J Neurogastroenterol Motil, 24 (2):226-232.
8. Surdea-Blaga T, Negrutiu DE, Palage M, Dumitrascu DL (2019). Food and Gastroesophageal Reflux Disease. Curr Med Chem, 26 (19):3497-3511.
9. Kethman W, Hawn M (2017). New Approaches to Gastroesophageal Reflux Disease. J Gastrointest Surg, 21 (9):1544-1552.
10. Chen J, Brady P (2019). Gastroesophageal Reflux Disease: Pathophysiology, Diagnosis, and Treatment. Gastroenterol Nurs, 42 (1):20-28.
11. Mermelstein J, Chait Mermelstein A, Chait MM (2018). Proton pump inhibitor-refractory gastroesophageal reflux dis-ease: challenges and solutions. Clin Exp Gastroenterol, 11:119-134.
12. Yadlapati R, DeLay K (2019). Proton Pump Inhibitor-Refractory Gastroesophageal Reflux Disease. Med Clin North Am, 103 (1):15-27.
13. Katz PO, Gerson LB, Vela MF (2013). Guidelines for the diagnosis and man-agement of gastroesophageal reflux dis-ease. Am J Gastroenterol, 108 (3):308-28.
14. Sandhu DS, Fass R (2018). Current Trends in the Management of Gastroesophageal Reflux Disease. Gut Liver, 12 (1):7-16.
15. Gyawali CP, Fass R (2018). Management of Gastroesophageal Reflux Disease. Gastro-enterology, 154 (2):302-318.
16. Delshad SD, Almario CV, Chey WD, Spie-gel BMR (2020). Prevalence of Gas-troesophageal Reflux Disease and Proton Pump Inhibitor-Refractory Symptoms. Gastroenterology, 158 (5):1250-1261.e2.
17. Gyawali CP (2017). Proton Pump Inhibitors in Gastroesophageal Reflux Disease: Friend or Foe. Curr Gastroenterol Rep, 19 (9):46.
18. Miyazaki H, Igarashi A, Takeuchi T, et al (2019). Vonoprazan versus proton-pump inhibitors for healing gastroesophageal reflux disease: A systematic review. J Gas-troenterol Hepatol, 34 (8):1316-1328.
19. Çelebi A, Aydın D, Kocaman O, et al (2016). Comparison of the effects of esomepra-zole 40 mg, rabeprazole 20 mg, lansopra-zole 30 mg, and pantoprazole 40 mg on intragastrıc pH in extensive metabolizer patients with gastroesophageal reflux dis-ease. Turk J Gastroenterol, 27 (5):408-414.
20. Sakurai K, Suda H, Fujie S, et al (2019). Short-Term Symptomatic Relief in Gas-troesophageal Reflux Disease: A Com-parative Study of Esomeprazole and Vonoprazan. Dig Dis Sci, 64 (3):815-822.
21. Czinn SJ, Blanchard S (2013). Gastroesoph-ageal reflux disease in neonates and in-fants: when and how to treat. Paediatr Drugs, 15 (1):19-27.
22. Qi Q, Wang R, Liu L, Zhao F, Wang S (2015). Comparative effectiveness and tolerability of esomeprazole and omepra-zole in gastro-esophageal reflux disease:A systematic review and meta-analysis. Int J Clin Pharmacol Ther, 53 (10):803-10.
23. Chiang HH, Wu DC, Hsu PI, et al (2019). Clinical efficacy of 60-mg dexlansopra-zole and 40-mg esomeprazole after 24 weeks for the on-demand treatment of gastroesophageal reflux disease grades A and B: a prospective randomized trial. Drug Des Devel Ther, 13:1347-1356.
24. Kinoshita Y, Ishimura N, Ishihara S (2018). Advantages and Disadvantages of Long-term Proton Pump Inhibitor Use. J Neu-rogastroenterol Motil, 24 (2):182-196.
25. Liang CM, Kuo MT, Hsu PI, et al (2017). First-week clinical responses to dexlan-soprazole 60 mg andesomeprazole 40 mg for the treatment of grades A and B gas-troesophageal reflux disease. World J Gas-troenterol, 23 (47):8395-8404.
26. Davidson G, Wenzl TG, Thomson M, et al (2013). Efficacy and safety of once-daily esomeprazole for the treatment of gas-troesophageal reflux disease in neonatal patients. J Pediatr, 163 (3):692-8.e1-2.
27. Hillman L, Yadlapati R, Thuluvath AJ, et al (2017). A review of medical therapy for proton pump inhibitor nonresponsive gastroesophageal reflux disease. Dis Esophagus, 30 (9):1-15.
28. Yu YY, Fang DC, Fan LL, et al (2014). Effi-cacy and safety of esomeprazole with flupentixol/melitracen in treating gas-troesophageal reflux disease patients with emotional disorders. J Gastroenterol Hepa-tol, 29 (6):1200-6.
29. Zacuto AC, Marks SL, Osborn J, et al (2012). The influence of esomeprazole and cisapride on gastroesophageal reflux during anesthesia in dogs. J Vet Intern Med, 26 (3):518-25.
30. Alzubaidi M, Gabbard S (2015). GERD: Di-agnosing and treating the burn. Cleve Clin Med,82(10):685-92.
31. Spechler SJ (2019). Proton Pump Inhibitors: What the Internist Needs to Know. Med Clin North Am,103(1):1-14.
32. Hatlebakk JG, Zerbib F, Bruley des Varan-nes S, et al (2016).Gastroesophageal Acid Reflux Control 5 Years After Antireflux Surgery, Compared With Long-term Esomeprazole Therapy. Clin Gastroenterol Hepatol, 14 (5):678-85.e3.
33. Devault KR, Johanson JF, Johnson DA, et al (2006). Maintenance of healed erosive esophagitis: a randomized six-month comparison of esomeprazole twenty mil-ligrams with lansoprazole fifteen milli-grams. Clin Gastroenterol Hepatol, 4 (7):852-9.
34. Goh KL, Benamouzig R, Sander P, Schwan T (2007). Efficacy of pantoprazole 20 mg daily compared with esomeprazole 20 mg daily in the maintenance of healed gas-troesophageal reflux disease: a random-ized, double-blind comparative trial - the EMANCIPATE study. Eur J Gastroenterol Hepatol, 19 (3):205-11.
35. Johnson DA, Benjamin SB, Vakil NB, et al (2001). Esomeprazole once daily for 6 months is effective therapy for maintain-ing healed erosive esophagitis and for controlling gastroesophageal reflux dis-ease symptoms: a randomized, double-blind, placebo-controlled study of effica-cy and safety. Am J Gastroenterol, 96 (1):27-34.
36. Labenz J, Armstrong D, Lauritsen K, et al (2005). Esomeprazole 20 mg vs. panto-prazole 20 mg for maintenance therapy of healed erosive oesophagitis: results from the EXPO study. Aliment Pharmacol Ther, 22 (9):803-11.
37. Lauritsen K, Devière J, Bigard MA, et al (2003). Esomeprazole 20 mg and lanso-prazole 15 mg in maintaining healed re-flux oesophagitis: Metropole study re-sults. Aliment Pharmacol Ther, 17 (3):333-41.
38. Talley NJ, Lauritsen K, Tunturi-Hihnala H, et al (2001). Esomeprazole 20 mg main-tains symptom control in endoscopy-negative gastro-oesophageal reflux dis-ease: a controlled trial of 'on-demand' therapy for 6 months. Aliment Pharmacol Ther, 15 (3):347-54.
39. Talley NJ, Venables TL, Green JR, et al (2002). Esomeprazole 40 mg and 20 mg is efficacious in the long-term manage-ment of patients with endoscopy-negative gastro-oesophageal reflux dis-ease: a placebo-controlled trial of on-demand therapy for 6 months. Eur J Gas-troenterol Hepatol, 14 (8):857-63.
40. Vakil NB, Shaker R, Johnson DA, et al (2001). The new proton pump inhibitor esomeprazole is effective as a mainte-nance therapy in GERD patients with healed erosive oesophagitis: a 6-month, randomized, double-blind, placebo-controlled study of efficacy and safety. Aliment Pharmacol Ther, 15 (7):927-35.
41. Gilger MA, Tolia V, Vandenplas Y, et al (2015). Safety and Tolerability of Esomeprazole in Children With Gas-troesophageal Reflux Disease. J Pediatr Gastroenterol Nutr, 60 Suppl 1:S16-23.
42. Mei J, Yu Y, Ma J, Yu X (2016). Evaluation of the effectiveness of esomeprazole treatment strategies in the management of patients with gastroesophageal reflux disease symptoms: a meta-analysis. Phar-mazie, 71 (5):285-91.
43. Takeshima F, Hashiguchi K, Onitsuka Y, et al (2015). Clinical Characteristics of Pa-tients with Gastroesophageal Reflux Dis-ease Refractory to Proton Pump Inhibi-tors and the Effects of Switching to 20 mg Esomeprazole on Reflux Symptoms and Quality of Life. Med Sci Monit, 21:4111-21.
44. Cardile S, Romano C (2012). Clinical utility of esomeprazole for treatment of gas-troesophageal reflux disease in pediatric and adolescent patients. Adolesc Health Med Ther, 3:27-31.
45. Petryszyn P, Staniak A, Grzegrzolka J (2016). Is the use of esomeprazole in gas-troesophageal reflux disease a cost-effective option in Poland? J Comp Eff Res, 5 (2):169-78.
46. Tang RS, Wu JC (2013). Managing peptic ul-cer and gastroesophageal reflux disease in elderly Chinese patients--focus on esomeprazole. Clin Interv Aging, 8:1433-43.
47. Richter JE, Kahrilas PJ, Johanson J, et al (2001). Efficacy and safety of esomepra-zole compared with omeprazole in GERD patients with erosive esophagitis:a randomized controlled trial. Am J Gastro-enterol, 96 (3):656-65.
48. Namikoshi T, Harada K, Hatta H, et al (2016). Prevalence of gastroesophageal reflux disease symptoms and effects of esomeprazole on the quality of life related to reflux and dyspepsia in patients on maintenance hemodialysis. Clin Exp Nephrol, 20 (1):134-42.
49. Goirand F, Le Ray I, Bardou M (2014). Pharmacokinetic evaluation of esomepra-zole for the treatment of gastroesophage-al reflux disease. Expert Opin Drug Metab Toxicol, 10 (9):1301-11.
50. Earp JC, Mehrotra N, Peters KE, et al (2017). Esomeprazole FDA Approval in Children With GERD: Exposure-Matching and Exposure-Response. J Pe-diatr Gastroenterol Nutr, 65 (3):272-277.
2. Kellerman R, Kintanar T (2017). Gastroesophageal Reflux Disease. Prim Care, 44 (4):561-573.
3. Barnhart DC (2016). Gastroesophageal reflux disease in children. Semin Pediatr Surg, 25 (4):212-8.
4. Maqbool A, Ryan MJ (2018). Gastroesophageal Reflux Disease and Aerodigestive Disorders. Curr Probl Pediatr Adolesc Health Care, 48 (3):85-98.
5. Patti MG (2016). An Evidence-Based Approach to the Treatment of Gastroesophageal Reflux Disease. JAMA Surg, 151 (1):73-8.
6. Mikami DJ, Murayama KM (2015). Physiology and pathogenesis of gastroesophageal reflux disease. Surg Clin North Am, 95 (3):515-25.
7. Quach DT, Nguyen TT, Hiyama T (2018). Abnormal Gastroesophageal Flap Valve Is Associated With High Gastresophageal Reflux Disease Questionnaire Score and the Severity of Gastroesophageal Reflux Disease in Vietnamese Patients With Upper Gastrointestinal Symptoms. J Neurogastroenterol Motil, 24 (2):226-232.
8. Surdea-Blaga T, Negrutiu DE, Palage M, Dumitrascu DL (2019). Food and Gastroesophageal Reflux Disease. Curr Med Chem, 26 (19):3497-3511.
9. Kethman W, Hawn M (2017). New Approaches to Gastroesophageal Reflux Disease. J Gastrointest Surg, 21 (9):1544-1552.
10. Chen J, Brady P (2019). Gastroesophageal Reflux Disease: Pathophysiology, Diagnosis, and Treatment. Gastroenterol Nurs, 42 (1):20-28.
11. Mermelstein J, Chait Mermelstein A, Chait MM (2018). Proton pump inhibitor-refractory gastroesophageal reflux dis-ease: challenges and solutions. Clin Exp Gastroenterol, 11:119-134.
12. Yadlapati R, DeLay K (2019). Proton Pump Inhibitor-Refractory Gastroesophageal Reflux Disease. Med Clin North Am, 103 (1):15-27.
13. Katz PO, Gerson LB, Vela MF (2013). Guidelines for the diagnosis and man-agement of gastroesophageal reflux dis-ease. Am J Gastroenterol, 108 (3):308-28.
14. Sandhu DS, Fass R (2018). Current Trends in the Management of Gastroesophageal Reflux Disease. Gut Liver, 12 (1):7-16.
15. Gyawali CP, Fass R (2018). Management of Gastroesophageal Reflux Disease. Gastro-enterology, 154 (2):302-318.
16. Delshad SD, Almario CV, Chey WD, Spie-gel BMR (2020). Prevalence of Gas-troesophageal Reflux Disease and Proton Pump Inhibitor-Refractory Symptoms. Gastroenterology, 158 (5):1250-1261.e2.
17. Gyawali CP (2017). Proton Pump Inhibitors in Gastroesophageal Reflux Disease: Friend or Foe. Curr Gastroenterol Rep, 19 (9):46.
18. Miyazaki H, Igarashi A, Takeuchi T, et al (2019). Vonoprazan versus proton-pump inhibitors for healing gastroesophageal reflux disease: A systematic review. J Gas-troenterol Hepatol, 34 (8):1316-1328.
19. Çelebi A, Aydın D, Kocaman O, et al (2016). Comparison of the effects of esomepra-zole 40 mg, rabeprazole 20 mg, lansopra-zole 30 mg, and pantoprazole 40 mg on intragastrıc pH in extensive metabolizer patients with gastroesophageal reflux dis-ease. Turk J Gastroenterol, 27 (5):408-414.
20. Sakurai K, Suda H, Fujie S, et al (2019). Short-Term Symptomatic Relief in Gas-troesophageal Reflux Disease: A Com-parative Study of Esomeprazole and Vonoprazan. Dig Dis Sci, 64 (3):815-822.
21. Czinn SJ, Blanchard S (2013). Gastroesoph-ageal reflux disease in neonates and in-fants: when and how to treat. Paediatr Drugs, 15 (1):19-27.
22. Qi Q, Wang R, Liu L, Zhao F, Wang S (2015). Comparative effectiveness and tolerability of esomeprazole and omepra-zole in gastro-esophageal reflux disease:A systematic review and meta-analysis. Int J Clin Pharmacol Ther, 53 (10):803-10.
23. Chiang HH, Wu DC, Hsu PI, et al (2019). Clinical efficacy of 60-mg dexlansopra-zole and 40-mg esomeprazole after 24 weeks for the on-demand treatment of gastroesophageal reflux disease grades A and B: a prospective randomized trial. Drug Des Devel Ther, 13:1347-1356.
24. Kinoshita Y, Ishimura N, Ishihara S (2018). Advantages and Disadvantages of Long-term Proton Pump Inhibitor Use. J Neu-rogastroenterol Motil, 24 (2):182-196.
25. Liang CM, Kuo MT, Hsu PI, et al (2017). First-week clinical responses to dexlan-soprazole 60 mg andesomeprazole 40 mg for the treatment of grades A and B gas-troesophageal reflux disease. World J Gas-troenterol, 23 (47):8395-8404.
26. Davidson G, Wenzl TG, Thomson M, et al (2013). Efficacy and safety of once-daily esomeprazole for the treatment of gas-troesophageal reflux disease in neonatal patients. J Pediatr, 163 (3):692-8.e1-2.
27. Hillman L, Yadlapati R, Thuluvath AJ, et al (2017). A review of medical therapy for proton pump inhibitor nonresponsive gastroesophageal reflux disease. Dis Esophagus, 30 (9):1-15.
28. Yu YY, Fang DC, Fan LL, et al (2014). Effi-cacy and safety of esomeprazole with flupentixol/melitracen in treating gas-troesophageal reflux disease patients with emotional disorders. J Gastroenterol Hepa-tol, 29 (6):1200-6.
29. Zacuto AC, Marks SL, Osborn J, et al (2012). The influence of esomeprazole and cisapride on gastroesophageal reflux during anesthesia in dogs. J Vet Intern Med, 26 (3):518-25.
30. Alzubaidi M, Gabbard S (2015). GERD: Di-agnosing and treating the burn. Cleve Clin Med,82(10):685-92.
31. Spechler SJ (2019). Proton Pump Inhibitors: What the Internist Needs to Know. Med Clin North Am,103(1):1-14.
32. Hatlebakk JG, Zerbib F, Bruley des Varan-nes S, et al (2016).Gastroesophageal Acid Reflux Control 5 Years After Antireflux Surgery, Compared With Long-term Esomeprazole Therapy. Clin Gastroenterol Hepatol, 14 (5):678-85.e3.
33. Devault KR, Johanson JF, Johnson DA, et al (2006). Maintenance of healed erosive esophagitis: a randomized six-month comparison of esomeprazole twenty mil-ligrams with lansoprazole fifteen milli-grams. Clin Gastroenterol Hepatol, 4 (7):852-9.
34. Goh KL, Benamouzig R, Sander P, Schwan T (2007). Efficacy of pantoprazole 20 mg daily compared with esomeprazole 20 mg daily in the maintenance of healed gas-troesophageal reflux disease: a random-ized, double-blind comparative trial - the EMANCIPATE study. Eur J Gastroenterol Hepatol, 19 (3):205-11.
35. Johnson DA, Benjamin SB, Vakil NB, et al (2001). Esomeprazole once daily for 6 months is effective therapy for maintain-ing healed erosive esophagitis and for controlling gastroesophageal reflux dis-ease symptoms: a randomized, double-blind, placebo-controlled study of effica-cy and safety. Am J Gastroenterol, 96 (1):27-34.
36. Labenz J, Armstrong D, Lauritsen K, et al (2005). Esomeprazole 20 mg vs. panto-prazole 20 mg for maintenance therapy of healed erosive oesophagitis: results from the EXPO study. Aliment Pharmacol Ther, 22 (9):803-11.
37. Lauritsen K, Devière J, Bigard MA, et al (2003). Esomeprazole 20 mg and lanso-prazole 15 mg in maintaining healed re-flux oesophagitis: Metropole study re-sults. Aliment Pharmacol Ther, 17 (3):333-41.
38. Talley NJ, Lauritsen K, Tunturi-Hihnala H, et al (2001). Esomeprazole 20 mg main-tains symptom control in endoscopy-negative gastro-oesophageal reflux dis-ease: a controlled trial of 'on-demand' therapy for 6 months. Aliment Pharmacol Ther, 15 (3):347-54.
39. Talley NJ, Venables TL, Green JR, et al (2002). Esomeprazole 40 mg and 20 mg is efficacious in the long-term manage-ment of patients with endoscopy-negative gastro-oesophageal reflux dis-ease: a placebo-controlled trial of on-demand therapy for 6 months. Eur J Gas-troenterol Hepatol, 14 (8):857-63.
40. Vakil NB, Shaker R, Johnson DA, et al (2001). The new proton pump inhibitor esomeprazole is effective as a mainte-nance therapy in GERD patients with healed erosive oesophagitis: a 6-month, randomized, double-blind, placebo-controlled study of efficacy and safety. Aliment Pharmacol Ther, 15 (7):927-35.
41. Gilger MA, Tolia V, Vandenplas Y, et al (2015). Safety and Tolerability of Esomeprazole in Children With Gas-troesophageal Reflux Disease. J Pediatr Gastroenterol Nutr, 60 Suppl 1:S16-23.
42. Mei J, Yu Y, Ma J, Yu X (2016). Evaluation of the effectiveness of esomeprazole treatment strategies in the management of patients with gastroesophageal reflux disease symptoms: a meta-analysis. Phar-mazie, 71 (5):285-91.
43. Takeshima F, Hashiguchi K, Onitsuka Y, et al (2015). Clinical Characteristics of Pa-tients with Gastroesophageal Reflux Dis-ease Refractory to Proton Pump Inhibi-tors and the Effects of Switching to 20 mg Esomeprazole on Reflux Symptoms and Quality of Life. Med Sci Monit, 21:4111-21.
44. Cardile S, Romano C (2012). Clinical utility of esomeprazole for treatment of gas-troesophageal reflux disease in pediatric and adolescent patients. Adolesc Health Med Ther, 3:27-31.
45. Petryszyn P, Staniak A, Grzegrzolka J (2016). Is the use of esomeprazole in gas-troesophageal reflux disease a cost-effective option in Poland? J Comp Eff Res, 5 (2):169-78.
46. Tang RS, Wu JC (2013). Managing peptic ul-cer and gastroesophageal reflux disease in elderly Chinese patients--focus on esomeprazole. Clin Interv Aging, 8:1433-43.
47. Richter JE, Kahrilas PJ, Johanson J, et al (2001). Efficacy and safety of esomepra-zole compared with omeprazole in GERD patients with erosive esophagitis:a randomized controlled trial. Am J Gastro-enterol, 96 (3):656-65.
48. Namikoshi T, Harada K, Hatta H, et al (2016). Prevalence of gastroesophageal reflux disease symptoms and effects of esomeprazole on the quality of life related to reflux and dyspepsia in patients on maintenance hemodialysis. Clin Exp Nephrol, 20 (1):134-42.
49. Goirand F, Le Ray I, Bardou M (2014). Pharmacokinetic evaluation of esomepra-zole for the treatment of gastroesophage-al reflux disease. Expert Opin Drug Metab Toxicol, 10 (9):1301-11.
50. Earp JC, Mehrotra N, Peters KE, et al (2017). Esomeprazole FDA Approval in Children With GERD: Exposure-Matching and Exposure-Response. J Pe-diatr Gastroenterol Nutr, 65 (3):272-277.
| Files | ||
| Issue | Vol 49 No 12 (2020) | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v49i12.4807 | |
| Keywords | ||
| Esomeprazole Meta-analysis Gastroesophageal reflux disease Clinical efficacy Safety | ||
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How to Cite
1.
HOU M, HU H, JIN C, YU X. Efficacy and Safety of Esomeprazole for the Treatment of Reflux Symptoms in Patients with Gastroesophageal Reflux Disease: A Systematic Review and Meta-Analysis. Iran J Public Health. 2020;49(12):2264-2274.
