Studies of gastro-oesophageal reflux treatment in cystic fibrosis and bronchiectasis

First author [ref]
Study type
nTreatmentCF symptomsExacerbationsFEV1Other outcomes
Cystic fibrosis
 Malfroot [134]
Prospective observational
16Cisapride therapyImproved weight gain and improved cough and wheezeN/AN/AN/A
 Brodzicki [135]
Prospective observational
19Cisapride or cisparide with ranitidine for 3 monthsN/AN/AN/AImproved GORD outcomes on pH analysis: decrease in reflux index, longest episode duration and the no. of episodes >5 min;
improvement of endoscopic picture post-treatment
van der Doef [123]
Prospective observational
218Gastric acid inhibition (proton pump inhibitors or histamine-2 receptor antagonists) for fat malabsorption or GORDN/AN/AGORD was associated with significantly reduced FEV1 and FVC
Patients with gastric acid inhibition had a significantly smaller yearly decline of MEF50 and MEF25–75%
GORD was associated with an earlier acquisition of P. aeruginosa and S. aureus
 Tran [136]
Prospective observational
15Lansoprazole 15 mg daily for 3 monthsImproved faecal steatorrhoeaN/AN/ASignificant improvements in fat mass nutritional status and bone mineral content
 Hendriks [137]
Prospective observational
14Lansoprazole 30 mg daily for 1 yearImproved faecal steatorrheoaN/AImproved TLC, RV and inspiratory muscle capacityImproved BMI, decreased fat losses and improved total body fat
 Dimango [138]
17PPI (esomeprazole 40 mg BD) for 36 weeksN/ATrend to earlier exacerbation and more frequent exacerbations in esomeprazole groupFEV1 unchangedNo change in Gastroesophageal Symptom Assessment Score or CF Quality of Life score between the two groups
 Zeybel [133]
Prospective observational
12Ivacaftor (CF patients with G511D mutations)N/AN/ABaseline FEV1 lower in patients with extra-oesophageal reflux symptomsImproved extra-oesophageal reflux symptoms using the Reflux Symptom Index and the Hull Airways Reflux Questionnaire
 Boesch [139]
Prospective observational
25Nissen fundoplicationN/AN/ANo change in FEV1 or body mass index after fundoplication;
children who had an FEV1 <60% predicted at time surgery had significantly improved FEV1 compared to those with FEV1 <60%
No mortality associated with fundoplication, but 12% had complications that required a subsequent surgical procedure
 Fathi [145]
Prospective observational
6Nissen fundoplicationN/A50% reduction in exacerbations 2 years post-operativelySmall but significant improvement in FEV1 and FVC 2 years post-operativelyImproved cough symptoms using the Leicester Cough Questionnaire
 Sheikh [146]
Retrospective observational
Nissen fundoplicationIncreased weight gainFewer pulmonary exacerbationsSlower decline in FEV1 2 years post-operativelyBetter pulmonary and nutritional outcomes were noted among patients with milder lung disease compared to those with severe lung disease;
no mortality associated with surgery
 Ahn [159]
Prospective observational
257PPI therapy (any type) for 6 monthsN/AN/AUnchanged
Subgroup analyses showed significant improvement in lung function in patients with high BMI related to the severity of obesity
 Hu [160]
Prospective observational
7Stretta radiofrequency (SRF) n=2
Laparoscopic fundoplication with or without hiatal hernia repair n=4
Combined n=1
ImprovedImproved exacerbations
Improved hospitalisations
N/AImproved GORD symptoms

Abbreviations: CF: cystic fibrosis; FEV1: forced expiratory volume in 1 s; GORD: gastro-oesophageal reflux; FVC: forced vital capacity; MEF50: maximal expiratory flow at 50 % of FVC; MEF25–75%: mean expiratory flow at 25–75% of FVC; TLC: total lung capacity; RV: residual volume; BMI: body mass index; RCT: randomised controlled trial; PPI: proton pump inhibitor.