Comparative Efficacy of Dexlansoprazole and Esomeprazole in the Treatment of Gastro-esophageal Reflux Disease

OBJECTIVE To compare the efficacy of dexlansoprazole with esomeprazole in healing erosive oesophagitis (EO), the maintenance of healed EO and the treatment of non-erosive reflux disease(NERD). METHODS Randomised controlled trials (RCTs) comparing dexlansoprazole or esomeprazole with either placebo or another PPI were systematically reviewed. Random-effect Meta-analyses and adjusted indirect comparisons were conducted to compare the treatment effect of dexlansoprazole and esomeprazole using a common comparator. The relative risk (RR) and 95% confidence interval (CI) were calculated. RESULTS The indirect comparisons revealed significant differences in symptom control of heartburn in patients with NERD at 4?weeks between two drugs: dexlansoprazole 30?mg was more effective than esomeprazole 20?mg or 40?mg (RR: 2.01, 95% CI: 1.15–3.51; RR: 2.17, 95% CI: 1.39–3.38). However, there were no statistically significant differences between the two drugs in EO healing and maintenance of healed EO. CONCLUSION It suggestes significantly better treatment effect in symptom control of heartburn in patients with NERD for dexlansoprazole against esomeprazole. No statistically significant differences are found in other EO outcomes. it is looking forward to have more high quality clinical randomized controlled trials to confirm the findings.