Study designs of evaluations included in the review
Randomised controlled trials (RCTs) were eligible for inclusion.
Specific interventions included in the review
Studies that compared acute treatment with PPI monotherapy with placebo were eligible for inclusion. The included studies used rabeprazole, esomeprazole, omeprazole and pantoprazole. Some studies had multiple treatment arms.
Participants included in the review
Studies of adults (aged 18 years or over) with NERD, i.e. symptoms of gastroesophageal reflux disease and negative upper endoscopy, were included if the patients had oesophagitis grade 0 or 1. The included studies used different systems to classify patients. The reviewers categorised patients into three groups: patients with negative endoscopy; patients with erythema and friability but no erosions; and all patients. For the comparison of PPI treatment in patients with NERD and EE, placebo-controlled studies of patients with endoscopically confirmed EE (Hetzel-Dent grades 2 to 4) were eligible and were included.
Outcomes assessed in the review
Studies that assessed the resolution of symptoms were eligible for inclusion. The review assessed:
heartburn resolution, defined as either complete or sufficient resolution;
complete resolution, defined as no heartburn during the previous 7 days); and
sufficient (or satisfactory) heartburn resolution, defined as less than 1 day of moderate heartburn during the previous 7 days.
The outcomes for patients with NERD were reported at 1, 2 and 4 weeks (where data permitted). Only complete resolution at 4 weeks was assessed for patients with EE.
How were decisions on the relevance of primary studies made?
Two reviewers independently selected studies and any disagreements were resolved by consensus. Inter-rater reliability was assessed using the kappa statistic.