{"title":"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","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":"{\"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}","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}
Anti-reflux therapy and mortality in patients with idiopathic pulmonary fibrosis and gastroesophageal reflux disease: a systematic review and meta-analysis.
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.