Background Though nitrates have been used in achalasia for a long time, the effectiveness of nitrates for achalasia is still controversial.
Objectives To quantify short-term and long-term effects of nitrate therapy in patients with achalasia.
Search strategy Trials were identified by searching the Cochrane Controlled Trials Register (Issue 4, 2001), MEDLINE (1966-2001), EMBASE (1980-2001), LILACS-Latin American and Caribbean health science literature (1982-2001) and CBM-Chinese Biomedical Database (1980-2000). Additionally, all references in the identified trials were checked for further relevant trials.
Selection criteria All randomised controlled trials involving achalasia patients given any type of nitrates were included.
Data collection amp; analysis Data were extracted By two independent observers based on the intention-to-treat principle. Odds ratios for the patients need to treat by invasive procedures, improvement of symptoms, LES pressure decrease, oesophageal emptying, and side effects were calculated. Numbers needed to treat (NNT) for avoiding invasive procedure, improvement of symptoms, oesophageal emptying, and numbers needed to harm (NNH) of side effects were also determined.
Main results Two randomised cross-over studies were found, But no results are included. Due to the design of the studies and the method of reporting the results in the original paper it was not possible to extract the necessary information to examine any of the outcomes. Authors have been contacted to obtain this information.
Reviewers’ conclusion We can conclude no implications for practice at this stage. Much more RCT data are needed to determine the effects of nitrates.
Citation： WEN Zhonghui,WANG Viping,Elizabeth Gardener,OU Yangqin. A systematic review: nitrates for achalasia. Chinese Journal of Evidence-Based Medicine, 2002, 02(2): 82-85. doi: Copy