Proton Pump Inhibitors in Pediatric Gastroesophageal Reflux Disease: A Systematic Review of Randomized Controlled Trials

Area of Science:

• Pediatric Gastroenterology
• Pharmacology
• Evidence-Based Medicine

Background:

• Gastroesophageal reflux disease (GERD) is common in children.
• Proton pump inhibitors (PPIs) are widely used, but their efficacy in pediatric populations requires further clarification.
• Understanding the safety and effectiveness of PPIs in different age groups is crucial for clinical practice.

Purpose of the Study:

• To systematically review the efficacy and safety of proton pump inhibitors (PPIs) in pediatric patients diagnosed with GERD.
• To evaluate PPI effectiveness in infants versus older children and adolescents.
• To identify potential adverse events associated with pediatric PPI use.

Main Methods:

• Systematic review of randomized controlled trials (RCTs).
• Literature search conducted on PubMed for studies published between June 2010 and June 2023.
• Inclusion criteria focused on patients aged 0-18 years with GERD treated with PPIs.

Main Results:

• PPIs demonstrated no significant benefit over placebo for reducing GERD symptoms in infants.
• In infants, PPIs did not consistently improve GERD symptoms, even with positional changes or feeding modifications.
• PPIs were effective in improving symptoms and promoting endoscopic healing in children and adolescents with GERD.
• Generally well-tolerated, but potential adverse events exist, particularly with long-term use.

Conclusions:

• Proton pump inhibitors are not effective for symptom reduction in infants with GERD.
• PPIs are effective for symptom management and achieving remission in older children and adolescents with GERD.
• While generally safe, the long-term safety profile and potential adverse events of PPIs in pediatric populations warrant consideration.