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Meta-Analysis
. 2025 Jul 1;59(6):512-523.
doi: 10.1097/MCG.0000000000002021.

Efficacy of Baclofen as Add-on Therapy for Refractory Gastroesophageal Reflux Disease: A Meta-analysis

Hongyi Dong  1 , Ying Luo  1 , Diangang Liu  1 , Xing Du  1 , Haijun Du  2
Affiliations
Meta-Analysis

Efficacy of Baclofen as Add-on Therapy for Refractory Gastroesophageal Reflux Disease: A Meta-analysis

Hongyi Dong et al. J Clin Gastroenterol. .

Abstract

Objectives: As a GABAB receptor agonist, baclofen has demonstrated efficacy in alleviating symptoms of refractory gastroesophageal reflux disease (r-GERD). This meta-analysis aims to evaluate the safety and effectiveness of baclofen as an add-on therapy for this condition.

Method: We conducted a comprehensive search of the PubMed, Embase, and Web of Science databases for studies published up until October 2023. Subsequently, we performed a meta-analysis encompassing all eligible trials.

Results: From 719 records, 10 studies were included, most of these studies were moderate risk. The findings demonstrated that the addition of baclofen as a supplementary treatment effectively improves symptoms (GERD Q score) in r-GERD (standardized mean difference=-0.78, 95% CI: -1.06 to -0.51, I2 =0%). The addition of this treatment also resulted in a decrease in the frequency of nonacidic reflux episodes (standardized mean difference=-0.93, 95% CI: -1.49 to -0.37, I2 =63%) and an improvement in DeMeester scores (standardized mean difference=-0.82, 95% CI: -1.61 to -0.04, I2 =81%) among patients with r-GERD when compared with the use of proton pump inhibitor (PPI) drugs alone. However, no significant disparity was observed in terms of reducing acid reflux episodes (standardized mean difference=-0.12, 95% CI: -0.49 to 0.19, I2 =0%) and proximal reflux (standardized mean difference=-0.47, 95% CI: -1.08 to 0.14, I2 =60%).

Conclusion: Baclofen as an add-on treatment can effectively improve the symptoms of patients with r-GERD and reduce the incidence of nonacidic reflux and improve DeMeester score. However, long-term use of baclofen leads to an increased incidence of side effects and is not effective in reducing the occurrence of acid reflux.

Keywords: MII-PH; baclofen; gastroesophageal reflux disease; medical treatment; refractory gastroesophageal reflux disease.

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Conflict of interest statement

Supported by: Natural Science Foundation of Beijing Province (L182048).

Figures

FIGURE 1
FIGURE 1
Study inclusion process.
FIGURE 2
FIGURE 2
Meta-analysis of GERD Q score between baclofen and control groups.
FIGURE 3
FIGURE 3
Meta-analysis of acid reflux episodes between baclofen and control groups.
FIGURE 4
FIGURE 4
Meta-analysis of nonacid reflux episodes between baclofen and control groups. A, Forest plots of nonacid reflux episodes. B, Sensitivity analysis of nonacid reflux episodes.
FIGURE 5
FIGURE 5
Meta-analysis of proximal reflux between baclofen and control groups. A, Forest plots of proximal reflux. B, Sensitivity analysis of proximal reflux.
FIGURE 6
FIGURE 6
Meta-analysis of DeMeester score between baclofen and control groups. A, Forest plots of DeMeester score. B, Sensitivity analysis of DeMeester score.
FIGURE 7
FIGURE 7
Revisions in the occurrence of adverse reactions over a period of time following administration of an identical dosage of baclofen (20 mg, tid).
See this image and copyright information in PMC

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