Meta AnalysisID 1551

初治幽门螺杆菌感染患者非铋剂四联疗法与三联疗法的比较

CRD42017081328

Non-bismuth quadruple (concomitant) therapy is suggested to be priority for naïve H. pylori patients in recent guidelines. We hope to compare the eradication efficacy of H. pylori between concomitant therapy and traditio

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Record Fields

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Meta Analysis Id
1551
Evidence Id
10109
Core Evidence Id
10109
Source Meta Analysis Id
1506
Herb2 Meta Analysis Id
HBMA001506
Crd Id
CRD42017081328
Title
Non-bismuth quadruple therapy versus triple therapy in patients with naïve Helicobacter pylori infection
Review Question
Non-bismuth quadruple (concomitant) therapy is suggested to be priority for naïve H. pylori patients in recent guidelines. We hope to compare the eradication efficacy of H. pylori between concomitant therapy and traditional triple therapy.
Study Type Included
We include randomized controlled trials to compare the eradication efficacy of H. pylori between concomitant therapy and triple therapy.
Condition Being Studied
Helicobacter pylori infection; concomitant therapy; triple therapy; antibiotic resistance
Participant
We include randomized controlled trials (RCTs) that fulfill the following criteria: (1) They compare the eradication efficacy of non-bismuth concomitant therapy to triple therapy in patients aged 18 years or greater with naïve H. pylori infection; (2) Non-bismuth concomitant therapy is defined as a PPI (Proton pump inhibitor) plus amoxicillin, clarithromycin and metronidazole/Tinidazole used twice a day. Triple therapy is defined as a PPI plus amoxicillin and clarithromycin (or metronidazole) used twice a day; (3) Both treatments are administered as first-line eradication. The studies which used modified triple or quadruple therapy containing other antibiotics and enrolled pediatric patients will be excluded. We will compare abstracts of annual meeting to published full texts of RCTs and then excluded those duplicated abstracts. The confirmation of H. pylori infection is based on any one of positive results: histology, UBT (urea breath test), rapid urease test, culture or HpSA (Helicobacter pylori stool antigen test). 
Animal
Human Disease Modelled
Intervention
Non-bismuth quadruple (concomitant) therapy group.
Comparator Control
Standard triple therapy group.
Main Outcome
Concomitant therapy given for 5 or 10 days was superior to 5- or 7- or 10-day PAC based triple therapy, but was not superior to 14-day triple therapy. Measures of effect Of the 639 articles identified, 23 RCTs including 3, 305 patients in the concomitant therapy group and 3, 327 patients in the triple therapy group were eligible. Overall, concomitant therapy was superior to triple therapy [Risk ratio (RR): 1.15; 95% confidence interval (CI):1.09-1.21; p<0.001]. However, there were significant heterogeneity (I²=74.0%, p<0.001). In the subgroup analysis, 5-day concomitant therapy was superior to 5-day triple therapy (RR: 1.30; 95% CI:1.04-1.62; p=0.02), 5-or 7-day concomitant therapy was superior to 7-day triple therapy (RR: 1.16; 95% CI: 1.12-1.21; p<0.001), and 5- or 7- or 10- or 14-day concomitant therapy was superior to 10-day triple therapy (RR: 1.15; 95% CI: 1.08-1.23; p<0.001). However, 5- or 10-day concomitant therapy was not superior to 14-day triple therapy (RR: 1.02; 95% CI: 0.89-1.16; p=0.796).
Outcome Measure
Additional Outcome
The secondary end point is the risk ratio of adverse effects in both groups. Measures of effect The frequency of adverse effects was significantly higher in concomitant therapy than triple therapy (RR: 1.19; 95% CI: 1.06-1.34; P=0.004).
Study Method
Meta-analysis
Keyword
Helicobacter Infections; Helicobacter pylori; Humans
Contact
Mei-Jyh Chen [email protected]
Organisational Affiliation
None.
Funding Source
None.
Other Selection Criteria
Final Publication
Systematic Review with Meta-Analysis: Concomitant Therapy vs. Triple Therapy for the First-Line Treatment of Helicobacter pylori Infection. Chen MJ, Chen CC, Chen YN, Chen CC, Fang YJ, Lin JT, Wu MS, Liou JM; Taiwan Gastrointestinal Disease Helicobacter Consortium. Am J Gastroenterol. 2018 Oct;113(10):1444-1457.
Same Topic Review
Published Protocol
Review Type
Language
Country
Taiwan
Review Stage
Review Completed published
First Submission Date
2017-11-11
Registration Date
2017-12-14
Anticipated Start Date
2017-11-11
Anticipated Completion Date
2017-12-11
Title Cn
初治幽门螺杆菌感染患者非铋剂四联疗法与三联疗法的比较
Title En
Non-bismuth quadruple therapy versus triple therapy in patients with naïve Helicobacter pylori infection
Bilingual Status
complete