Double‐blind, placebo‐controlled study with alginate suspension for laryngopharyngeal reflux disease

Tseng, Wen‐Hsuan; Tseng, Ping‐Huei; Wu, Jiafeng; Hsu, Ya-Chin; Lee, Ting-Yi; Ni, Yen‐Hsuan; Wang, Hsiu-Po; Hsiao, Tzu-Chien; Hsu, Wei‐Chung

doi:10.1002/lary.27111

Cited by 29 publications

(30 citation statements)

References 30 publications

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“…15,16 Alginates are natural polysaccharides that form a raft on top of the gastric contents to generate a mechanical barrier, thereby preventing reflux outside the stomach, and reducing or preventing the contact of gastric contents with the esophageal and laryngeal mucosa. [16][17][18] Moreover, an in vitro study has shown that alginate has an inherent ability to effectively inhibit the enzymatic action of pepsin and to protect human esophageal mucosa against acid-induced damage for a prolonged period after application. [17][18][19] Another relevant therapeutic agent in the current context is hyaluronic acid, which also has a mucoadhesive effect.…”

Section: Introductionmentioning

confidence: 99%

“…[16][17][18] Moreover, an in vitro study has shown that alginate has an inherent ability to effectively inhibit the enzymatic action of pepsin and to protect human esophageal mucosa against acid-induced damage for a prolonged period after application. [17][18][19] Another relevant therapeutic agent in the current context is hyaluronic acid, which also has a mucoadhesive effect. However, our literature review found that the effect of hyaluronic acid on the laryngeal mucosa in the context of LPR has not been studied to date.…”

Section: Introductionmentioning

confidence: 99%

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Laryngeal Mucosa Alterations in Mice Model of Gastroesophageal Reflux: Effects of Topical Protection

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et al. 2020

The Laryngoscope

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Objectives/Hypothesis: The objectives of this study were to evaluate laryngeal inflammation and mucosal integrity in a murine model of reflux disease and to assess the protective effects of topical agents including alginate, hyaluronic acid, and cashew gum. Study Design: Animal study. Methods: A surgical murine model of reflux disease was evaluated at 3 or 7 days postsurgery, and laryngeal samples were collected to measure inflammation (wet weight and myeloperoxidase [MPO]) and mucosal integrity (transepithelial resistance [TER] and mucosal permeability to fluorescein). Additional groups of animals were administered one of several topical agents (alginate, hyaluronic acid, or cashew gum) daily, and laryngeal inflammation and mucosal integrity were evaluated at 3 days postsurgery. Results: At 3 days, and not 7 days postsurgery, we observed increased laryngeal wet weight and MPO, decreased laryngeal TER, and increased laryngeal mucosa permeability. Alginate partially decreased laryngeal inflammation (wet weight and not MPO) and dramatically improved laryngeal mucosal integrity. Conversely, hyaluronic acid eliminated the inflammation; however, it had no effect on laryngeal mucosal integrity impairment. Cashew gum eliminated laryngeal inflammation as well as the impairment in laryngeal mucosal integrity. Conclusions: This study shows that a surgical model of reflux disease induced laryngeal inflammation and impairment in laryngeal barrier function. These observed alterations were partially attenuated by alginate and hyaluronic acid and completely reversed by cashew gum.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Laryngeal Mucosa Alterations in Mice Model of Gastroesophageal Reflux: Effects of Topical Protection

Figueiredo

Sales

Nicolau³

et al. 2020

The Laryngoscope

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“…Among the 15 placebo RCTs, two trials were excluded from the analysis because the treatment was only based on alginate; one study was excluded due to use of voice therapy in addition to PPIs . Two studies were considered as inadmissible due to insufficient information in the publications (i.e., percentage of patients who had > 50% of symptoms improvement) .…”

Section: Resultsmentioning

confidence: 99%

“…Of the 72 qualified articles, we found 15 placebo RCTs, 13 prospective controlled trials (with or without randomization), 40 prospective uncontrolled studies, and four retrospective case series (Supporting Supporting information Table 1). The ELs are described in Figure . Seven studies were excluded due to overlapping patient populations …”

Section: Resultsmentioning

confidence: 99%

“…26,43,[84][85][86] In trials that based the diagnosis on both signs and symptoms, more than 40% of the included studies did not provide information about the exclusion criterias 37,39,[45][46][47][48][49][50]52,53,[55][56][57][58]62,75,76,85,86 or did not exclude some major cofounding factors such as smoking or alcoholism, representing a selection bias according to our analysis with TARB. 3,21,31,33,[40][41][42]50,59,72,82,83 Overall, four main different medical regimens were identified with a duration ranging from 4 to 54 weeks:…”

Section: Overview Of Clinical and Epidemiological Characteristics In mentioning

confidence: 99%

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Clinical outcomes of laryngopharyngeal reflux treatment: A systematic review and meta‐analysis

et al. 2018

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Objectives To investigate the therapeutic benefit of proton pump inhibitors (PPIs) over placebo in patients with laryngopharyngeal reflux (LPR) and to analyze the epidemiological factors of heterogeneity in the literature. Methods An electronic literature search was conducted to identify articles published between 1990 and 2018 about clinical trials describing the efficiency of medical treatment(s) on LPR. First, a meta‐analysis of placebo randomized controlled trials (RCTs) comparing PPIs versus placebo was conducted according to diet. The heterogeneity, response to PPIs, and evolution of clinical scores were analyzed for aggregate results. Second, a systematic review of diagnosis methods, clinical outcome of treatment, and therapeutic regimens was performed using the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses statement. Results The search identified 1,140 relevant publications, of which 72 studies met the inclusion criteria for a total of 5,781 patients. Ten RCTs were included in the meta‐analysis. The combined relative risk was 1.31 in favor of PPIs and increased to 1.42 when patients did not receive diet recommendations. Randomized controlled trials were characterized by a significant heterogeneity due to discrepancies in clinical therapeutic outcomes, diagnosis methods (lack of gold standard diagnostic tools), and therapeutic scheme. The epidemiological analysis of all articles supports the existence of these discrepancies in the entire literature. In particular, many symptoms and signs commonly encountered in LPR are not assessed in the treatment effectiveness. The lack of diagnosis precision and variability of inclusion criteria particularly create bias in all reported and included articles. Conclusion This meta‐analysis supports a mild superiority of PPIs over placebo and the importance of diet as additional treatment but demonstrates the heterogeneity between studies, limiting the elaboration of clear conclusions. International recommendations are proposed for the development of future trials. Laryngoscope, 129:1174–1187, 2019

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In response to Double‐blind, placebo‐controlled study with alginate suspension for laryngopharyngeal reflux disease

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Double‐blind, placebo‐controlled study with alginate suspension for laryngopharyngeal reflux disease

Abstract: 2. Laryngoscope, 128:2252-2260, 2018.

Cited by 29 publications

References 30 publications

Laryngeal Mucosa Alterations in Mice Model of Gastroesophageal Reflux: Effects of Topical Protection

Laryngeal Mucosa Alterations in Mice Model of Gastroesophageal Reflux: Effects of Topical Protection

Clinical outcomes of laryngopharyngeal reflux treatment: A systematic review and meta‐analysis

In response to Double‐blind, placebo‐controlled study with alginate suspension for laryngopharyngeal reflux disease

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