H2-receptor antagonists in the treatment of functional (nonulcer) dyspepsia:: a meta-analysis of randomized controlled clinical trials

Aim: To perform a meta-analysis evaluating the efficacy of H-2-receptor antagonists in functional (nonulcer) dyspepsia. Selection of studies: A Medline search was used to identify placebo controlled randomized clinical trials, using the subject headings dyspepsia and H-2-receptor antagonist. Outcome measures: Global assessment by the patient of dyspepsia symptoms, improvement of epigastric pain and complete relief of epigastric pain. Results: Twenty-two studies met the inclusion criteria, 15 of which reported the active drug to be superior to placebo. Many studies suffered from suboptimal study design, The odds ratio in favour of active drug was 1.48 (95% confidence interval: 0.9-2.3) for global assessment of dyspepsia symptoms, 2.3 (95% CI: 1.6-3.3) for improvement of epigastric pain, and 1.8 (95% CI: 1.2-2.8) for complete relief of epigastric pain. Conclusion: There is some evidence that H2-receptor antagonists are superior to placebo in functional dyspepsia, but larger studies evaluating higher doses of H-2-receptor antagonists and of longer duration are necessary to determine the exact effect size.