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