Sequential or concomitant therapy for eradication of Helicobacter pylori infection: A systematic review and meta‐analysis. Issue 9 (September 2015)

• Record Type: Journal Article
• Authors: Kim, Joon Sung; Park, Sung Min; Kim, Byung‐Wook
• Is Part Of: Journal of gastroenterology and hepatology. Volume 30:Issue 9(2015:Sep.)
• Page Start: 1338
• Page End: 1345
• Publication Date: 2015-09
• Subjects: Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Liver Diseases -- Periodicals; 616.33
• DOI: 10.1111/jgh.12984
• Languages: English
• ISSNs: 0815-9319

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="jgh12984-sec-0001" sec-type="section"> <title>Background and Aim</title> <p>Eradication of <italic>H</italic><italic>elicobacter pylori</italic> (<italic>H</italic><italic>. pylori</italic>) infection with triple therapy (TT) has declined in many countries prompting the search for alternative regimens. Sequential therapy (ST) and concomitant therapy (CT) have been suggested as first‐line regimens in areas of high clarithromycin resistance. We performed a meta‐analysis to compare the eradication rates of CT with ST for <italic>H</italic><italic>. pylori</italic>.</p> </sec> <sec id="jgh12984-sec-0002" sec-type="section"> <title>Methods</title> <p>A comprehensive literature search for studies comparing the efficacy of CT with ST was performed. Dichotomous data were pooled to obtain the odds ratio (OR) of the eradication rate with 95% confidence intervals (CIs). The eradication rates were considered both on an intention‐to‐treat (ITT) and on a per‐protocol (PP) bases.</p> </sec> <sec id="jgh12984-sec-0003" sec-type="section"> <title>Results</title> <p>A total of 7 studies provided data on 2412 adult patients. Pooled estimates of the studies revealed no significant differences between CT and ST. The pooled OR was 1.116 (95% CI: 0.795–1.567, <italic>P</italic> = 0.526) for ITT analysis and 1.153 (95% CI: 0.793–1.677, <italic>P</italic> = 0.455) for PP analysis. There was no difference in the rate of adverse events (OR: 1.229, 95% CI: 0.971–1.556, <italic>P</italic> = 0.086) and compliance (OR: 0.945, 95% CI: 0.722–1.237, <italic>P</italic> = 0.681) between the two regimens. Subgroup analysis was performed to compare CT of 10 days and 5 days with ST of 10 days. The pooled OR was 1.518 for CT of 10days and 0.636 for CT of 5 days.</p> </sec> <sec id="jgh12984-sec-0004" sec-type="section"> <title>Conclusions</title> <p>CT regimens did not achieve higher eradication rates compared with the ST regimen. The adverse events and adherence to medications were not different between the two regimens.</p> </sec> </abstract>