Joon Sung Kim1, Jeong-Seon Ji2, Hwang Choi1, Joo Hyun Kim3. 1. Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea, 56, Dongsu-ro, Bupyeong-gu, Incheon 403-720, Republic of Korea. 2. Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea, 56, Dongsu-ro, Bupyeong-gu, Incheon 403-720, Republic of Korea. Electronic address: jjsdr@catholic.ac.kr. 3. Newport High School, Bellevue, WA, USA.
Abstract
BACKGROUND AND OBJECTIVE: Eradication rate of Helicobacter pylori infection with triple therapy (TT) has declined in part to increased antibiotic resistance. Sequential therapy (ST) has shown promise in several meta-analyses. However, most of the studies included in previous meta-analyses were from Italy. The aim of this study was to compare the efficacy of ST with that of TT in Asia by performing a meta-analysis of studies from Asia. MATERIALS AND METHODS: We performed a comprehensive literature search for studies comparing the efficacy of ST with TT. Randomised controlled trials investigated in the Asian population were included. The odds ratios (OR) of eradicating H. pylori infection after ST compared with TT were pooled. The eradication rates were considered both on an intention-to-treat (ITT) and on a per-protocol basis (PP). RESULTS: A total of nine studies provided data on 3074 adult patients. The odds ratio (OR) for eradication of H. pylori with ST compared with TT was 1.768 (95% CI: 1.476-2.117, P=0.000) for ITT analysis and 1.997 (95% CI: 1.607-2.480, P=0.000) for PP analysis. The pooled eradication rates of ITT analysis was 81.3% (95% CI: 76.5-85.3) for the ST group and 70.8% (95% CI: 64.6-76.4) for the TT group. The pooled eradication rates of PP analysis was 87.6% (95% CI: 84.1-90.5) for the ST group and 77.1% (95% CI: 70.9-82.3) for the TT group. There was no difference in the rate of adverse events between ST and TT (OR 0.945, 95% CI: 0.874-1.238, P=0.658). CONCLUSION: ST appears to be better than TT in the eradication of H. pylori in Asia. These results suggest that ST may be a reasonable choice for first line therapy in Asia.
BACKGROUND AND OBJECTIVE: Eradication rate of Helicobacter pylori infection with triple therapy (TT) has declined in part to increased antibiotic resistance. Sequential therapy (ST) has shown promise in several meta-analyses. However, most of the studies included in previous meta-analyses were from Italy. The aim of this study was to compare the efficacy of ST with that of TT in Asia by performing a meta-analysis of studies from Asia. MATERIALS AND METHODS: We performed a comprehensive literature search for studies comparing the efficacy of ST with TT. Randomised controlled trials investigated in the Asian population were included. The odds ratios (OR) of eradicating H. pylori infection after ST compared with TT were pooled. The eradication rates were considered both on an intention-to-treat (ITT) and on a per-protocol basis (PP). RESULTS: A total of nine studies provided data on 3074 adult patients. The odds ratio (OR) for eradication of H. pylori with ST compared with TT was 1.768 (95% CI: 1.476-2.117, P=0.000) for ITT analysis and 1.997 (95% CI: 1.607-2.480, P=0.000) for PP analysis. The pooled eradication rates of ITT analysis was 81.3% (95% CI: 76.5-85.3) for the ST group and 70.8% (95% CI: 64.6-76.4) for the TT group. The pooled eradication rates of PP analysis was 87.6% (95% CI: 84.1-90.5) for the ST group and 77.1% (95% CI: 70.9-82.3) for the TT group. There was no difference in the rate of adverse events between ST and TT (OR 0.945, 95% CI: 0.874-1.238, P=0.658). CONCLUSION:ST appears to be better than TT in the eradication of H. pylori in Asia. These results suggest that ST may be a reasonable choice for first line therapy in Asia.
Authors: Faisal Rasheed; Barry James Campbell; Hanafiah Alfizah; Andrea Varro; Rabaab Zahra; Yoshio Yamaoka; David Mark Pritchard Journal: Helicobacter Date: 2014-05-14 Impact factor: 5.753
Authors: Joon Sung Kim; Byung-Wook Kim; Su Jin Hong; Jin Il Kim; Ki-Nam Shim; Jie-Hyun Kim; Gwang Ho Baik; Sang Wook Kim; Hyun Joo Song; Ji Hyun Kim Journal: Gut Liver Date: 2016-07-15 Impact factor: 4.519