H-2-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 ant agonists in functional (nonulcer) dyspepsia. Selection of studies: A Medline search was used to identify placebo control led randomized clinical trials, using the subject headings dyspepsia and H- 2-receptor antagonist. Outcome measures: Global assessment by the patient of dyspepsia symptoms, i mprovement of epigastric pain and complete relief of epigastric pain. Results: Twenty-two studies met the inclusion criteria, 15 of which reporte d the active drug to be superior to placebo. Many studies suffered from sub optimal 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 superio r to placebo in functional dyspepsia, but larger studies evaluating higher doses of H-2-receptor antagonists and of longer duration are necessary to d etermine the exact effect size.