WITHDRAWN: Pharmacological interventions for non-ulcer dyspepsia

Area of Science:

• Gastroenterology
• Clinical Pharmacology

Background:

• Non-ulcer dyspepsia (NUD) is the most common cause of upper gastrointestinal symptoms.
• The pathophysiology and optimal treatment for NUD remain poorly understood.
• Dyspepsia treatments in the UK incur significant annual costs.

Purpose of the Study:

• To evaluate the effectiveness of six drug classes for NUD symptom and quality of life improvement.
• Assessed drugs include antacids, H2 antagonists, PPIs, prokinetics, mucosal protectants, and antimuscarinics.

Main Methods:

• Systematic review of randomized controlled trials (RCTs).
• Searched multiple databases (CENTRAL, MEDLINE, EMBASE, CINAHL, SIGLE) and contacted experts.
• Included RCTs comparing drug classes or placebo for NUD; two authors independently assessed data.

Main Results:

• Prokinetics, H2RAs, and PPIs demonstrated significantly greater effectiveness than placebo.
• Bismuth salts showed a trend towards superiority over placebo, though not statistically significant.
• Antacids and sucralfate did not show statistically significant superiority over placebo; prokinetic results may be affected by publication bias.

Conclusions:

• Anti-secretory therapies show potential efficacy in NUD.
• Interpreting prokinetic therapy effectiveness is challenging due to potential publication bias.
• Drug effects are likely modest; long-term use necessitates cost-effectiveness and tolerability assessments.