Literature review for - Flourish Paediatrics

Level of evidence I (aetiology) IV (intervention)
Definition of Not defined
Not defined
breastfeeding
Intervention/
comparator
N
cisapride vs placebo vs non-surgical treatments for
symptoms of GOR and risk of adverse effects
Trials that measured the risk of adverse events with
cisapride included 190 participants
40° supine body position on infant regurgitation, refluxassociated
symptoms and acid reflux.
30 infants. 52 originally approached (58%)
Population/study
information
Trials compared symptoms of
GOR after treatment with cisapride or no treatment
included including 262 participants
Searched databases in 2009 for RCTs comparing oral
cisapride therapy with placebo or other non-surgical
treatments for children diagnosed
with GOR. (excluded trials in which majority of subjects
were less than 28 days of age)
Ten trials met the inclusion criteria.
Eight trials compared symptoms of GOR after treatment
with cisapride or no treatment. One study compared
cisapride with two dietary interventions, carob bean
thickener and corn syrup
Between 2007 and 2008, the MC-AR Bed was proposed to
parents presenting with infants who were referred because of
frequent regurgitation (>4 times/day) of at least 2 weeks
duration, infant distress time related to feeding
Thirty of 52 infants presenting with GOR were evaluated in
the Multicare AR-Bed. The Infant- Gastroesophageal Reflux
Questionnaire-Revised (I-GERQ-R) and an oesophageal pH
monitoring were performed at
inclusion and after 1 week.
Adverse events (principally diarrhoea) were reported in
four trials
Quality P 0
Results
The pooled OR (random-effects model) for cisapride 8/30 (27%) infants did not tolerate the
versus placebo for ’same or worse’ symptoms versus 40° positioning, and had to be taken out of the study within
’improvement’ based on seven trials was 0.34 (0.10, the first 2 days. In 22/30 (73%) infants
1.19).
the I-GERQ-R and acid reflux decreased significantly with
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