Anti-reflux therapy and mortality in patients with idiopathic pulmonary fibrosis and gastroesophageal reflux disease: a systematic review and meta-analysis.

IF 0.8 Q4 RESPIRATORY SYSTEM
Konstantinos Dodos, Tsampika-Vasileia Kalamara, Nikolaos Trakas, Alexandru Corlateanu, Vasiliki Epameinondas Georgakopoulou
{"title":"Anti-reflux therapy and mortality in patients with idiopathic pulmonary fibrosis and gastroesophageal reflux disease: a systematic review and meta-analysis.","authors":"Konstantinos Dodos, Tsampika-Vasileia Kalamara, Nikolaos Trakas, Alexandru Corlateanu, Vasiliki Epameinondas Georgakopoulou","doi":"10.4081/monaldi.2025.3349","DOIUrl":null,"url":null,"abstract":"<p><p>Gastroesophageal reflux disease (GERD) and idiopathic pulmonary fibrosis (IPF) frequently coexist, with GERD potentially exacerbating IPF progression through microaspiration and pulmonary inflammation. This systematic review and meta-analysis assessed the impact of anti-reflux therapy, including proton pump inhibitors and H2-receptor antagonists, on mortality outcomes in IPF patients with concurrent GERD. A systematic search identified six eligible studies, including 2874 patients, for quantitative synthesis. Results indicate that anti-reflux therapy may reduce IPF-related mortality, with a pooled relative risk (RR) of 0.79 [95% confidence interval (CI): 0.55-1.33], although this finding was not statistically significant. However, no significant effect was observed on overall mortality (pooled RR: 0.97, 95% CI: 0.74-1.25). Study heterogeneity was moderate (I²=60%), reflecting variability in study designs, populations, and therapeutic regimens. The observational nature of most studies highlights the need for randomized controlled trials to better understand anti-reflux therapy's role in IPF management. While anti-reflux therapy was associated with a potential reduction in IPF-related mortality (RR: 0.79, 95% CI: 0.55-1.33), no significant effect on overall mortality was observed (RR: 0.97, 95% CI: 0.74-1.25). Future research should also evaluate the long-term safety of anti-reflux therapy, given concerns about complications such as infections and renal impairment. This analysis underscores the importance of tailored treatment approaches in IPF patients with GERD to optimize clinical outcomes.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8000,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Monaldi Archives for Chest Disease","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4081/monaldi.2025.3349","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
引用次数: 0

Abstract

Gastroesophageal reflux disease (GERD) and idiopathic pulmonary fibrosis (IPF) frequently coexist, with GERD potentially exacerbating IPF progression through microaspiration and pulmonary inflammation. This systematic review and meta-analysis assessed the impact of anti-reflux therapy, including proton pump inhibitors and H2-receptor antagonists, on mortality outcomes in IPF patients with concurrent GERD. A systematic search identified six eligible studies, including 2874 patients, for quantitative synthesis. Results indicate that anti-reflux therapy may reduce IPF-related mortality, with a pooled relative risk (RR) of 0.79 [95% confidence interval (CI): 0.55-1.33], although this finding was not statistically significant. However, no significant effect was observed on overall mortality (pooled RR: 0.97, 95% CI: 0.74-1.25). Study heterogeneity was moderate (I²=60%), reflecting variability in study designs, populations, and therapeutic regimens. The observational nature of most studies highlights the need for randomized controlled trials to better understand anti-reflux therapy's role in IPF management. While anti-reflux therapy was associated with a potential reduction in IPF-related mortality (RR: 0.79, 95% CI: 0.55-1.33), no significant effect on overall mortality was observed (RR: 0.97, 95% CI: 0.74-1.25). Future research should also evaluate the long-term safety of anti-reflux therapy, given concerns about complications such as infections and renal impairment. This analysis underscores the importance of tailored treatment approaches in IPF patients with GERD to optimize clinical outcomes.

特发性肺纤维化和胃食管反流病患者的抗反流治疗和死亡率:一项系统回顾和荟萃分析
胃食管反流病(GERD)和特发性肺纤维化(IPF)经常共存,GERD可能通过微吸和肺部炎症加剧IPF的进展。本系统综述和荟萃分析评估了抗反流治疗(包括质子泵抑制剂和h2受体拮抗剂)对IPF合并GERD患者死亡率结果的影响。系统检索确定了6项符合条件的研究,包括2874例患者,用于定量合成。结果表明,抗反流治疗可降低ipf相关死亡率,合并相对危险度(RR)为0.79[95%可信区间(CI): 0.55-1.33],尽管这一发现无统计学意义。然而,未观察到对总死亡率有显著影响(合并RR: 0.97, 95% CI: 0.74-1.25)。研究异质性为中等(I²=60%),反映了研究设计、人群和治疗方案的可变性。大多数研究的观察性突出了随机对照试验的必要性,以更好地了解抗反流治疗在IPF管理中的作用。虽然抗反流治疗与ipf相关死亡率的潜在降低相关(RR: 0.79, 95% CI: 0.55-1.33),但未观察到对总死亡率的显著影响(RR: 0.97, 95% CI: 0.74-1.25)。未来的研究还应该评估抗反流治疗的长期安全性,考虑到感染和肾脏损害等并发症。该分析强调了针对IPF合并GERD患者量身定制治疗方法以优化临床结果的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
3.60
自引率
0.00%
发文量
1
审稿时长
12 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信