Safety and efficacy of Proton-pump inhibitors when used with Alginate therapy for GERD

Combining Proton-pump inhibitors with Alginate improves the symptoms associated with heartburn and increased days without heartburn, with no significant adverse effects.

To assess the effectiveness and safety of the Proton-pump inhibitors (PPIs) + Alginate compared to using PPIs monotherapy for gastroesophageal reflux disease (GERD).

Extensive database search included exploring Embase, PubMed and Cochrane Library for randomized trials comparing the effectiveness of PPIs when used along with Alginate versus PPI monotherapy for the treatment of GERD. They were screened and reckoned for the risk of bias. Later, the statistical analysis using Rev Man 5.4 software was done.

Four RCTs involving 608 patients were investigated. The increase in heartburn scores in the combination group compared to the control group was observed before initiating the treatment and afterwards, but the disparity was not statistically noteworthy [Standard Mean Difference (SMD) = − 0.29, 95% CI (− 0.78, 0.19)]. 

Similarly, there was no significant difference in the change in the Heartburn Reflux Dyspepsia Questionnaire (HRDQ) score, the number of days without heartburn during the 28-day treatment period, reflux score, or HRDQ regurgitation score. Likewise, there was no marked disparity in adverse events between these groups [OR = 0.93, 95% CI (0.58, 1.47)].

When treating GERD, combining PPIs with Alginate yields enhanced efficacy compared to using PPIs alone, although without significant disparity, and Alginate doesn't elevate adverse event occurrences in PPI treatment. Further categorization of GERD subtypes and additional high-quality studies are necessary to advance the treatment strategy for GERD-related conditions.