Backgroung: For a long time, laryngopharyngeal reflux disease (LPRD) has been treated by proton pump inhibitors (PPIs) with an uncertain success rate.
Aim: To shed light the current therapeutic strategies used for LPRD in order to analysis the rationale in the LPRD treatment.
Methods: Three authors conducted a PubMed search to identify papers published between January 1990 and February 2019 about the treatment of LPRD. Clinical prospective or retrospective studies had to explore the impact of medical treatment(s) on the clinical presentation of suspected or confirmed LPRD. The criteria for considering studies for the review were based on the population, intervention, comparison, and outcome framework.
Results: The search identified 1355 relevant papers, of which 76 studies met the inclusion criteria, accounting for 6457 patients. A total of 64 studies consisted of empirical therapeutic trials and 12 were studies where authors formally identified LPRD with pH-monitoring or multichannel intraluminal impedance-pH monitoring (MII-pH). The main therapeutic scheme consisted of once or twice daily PPIs for a duration ranged from 4 to 24 wk. The most used PPIs were omeprazole, esomeprazole, rabeprazole, lansoprazole and pantoprazole with a success rate ranging from 18% to 87%. Other composite treatments have been prescribed including PPIs, alginate, prokinetics, and H2 Receptor antagonists.
Conclusion: Regarding the development of MII-pH and the identification of LPRD subtypes (acid, nonacid, mixed), future studies are needed to improve the LPRD treatment considering all subtypes of reflux.
Keywords: Laryngitis; Laryngopharyngeal; Proton pump inhibitors; Reflux; Treatment.
©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
Conflict of interest statement
Conflict-of-interest statement: The authors declare no conflicts of interest.
pH Impedance and High-Resolution Manometry in Laryngopharyngeal Reflux Disease High-Dose Proton Pump Inhibitor FailuresTL Carroll et al. Laryngoscope 122 (11), 2473-81. PMID 22965767.For recalcitrant LPRD subjects who fail empiric high-dose BID PPI therapy, this study demonstrated significant NAR or BAR in 74% of subjects. Evaluation by MII and HRM pe …
Double-blind, Placebo-Controlled Study With Alginate Suspension for Laryngopharyngeal Reflux DiseaseWH Tseng et al. Laryngoscope 128 (10), 2252-2260. PMID 29399800. - Randomized Controlled TrialThis study showed that liquid alginate suspension was well tolerated by LPRD patients. It effectively improved symptoms and reflux numbers but was unable to show superior …
Weaning of Proton Pump Inhibitors in Patients With Suspected Laryngopharyngeal Reflux DiseaseRJ Lin et al. Laryngoscope 128 (1), 133-137. PMID 28730666.Approximately 66% of patients who were on PPIs for LPRD were successfully weaned. High BMI was significantly predictive of failure to wean.
Systematic Review: Proton Pump Inhibitors (PPIs) for the Healing of Reflux Oesophagitis - A Comparison of Esomeprazole With Other PPIsSJ Edwards et al. Aliment Pharmacol Ther 24 (5), 743-50. PMID 16918878. - ReviewEsomeprazole consistently demonstrates higher healing rates when compared with standard dose proton pump inhibitors.
Pharmacological Treatment of Children With Gastro-Oesophageal RefluxM Tighe et al. Cochrane Database Syst Rev (11), CD008550. PMID 25419906. - ReviewModerate evidence was found to support the use of PPIs, along with some evidence to support the use of H₂ antagonists in older children with GORD, based on improvement in …
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