Comparative efficacy and safety of Potassium-Competitive Acid Blocker (P-CAB) based dual, triple and quadruple regimens for first line H. pylori infection treatment: A systematic review and network meta-analysis.
Am J Gastroenterol
; 2024 Sep 19.
Article
em En
| MEDLINE
| ID: mdl-39298553
ABSTRACT
BACKGROUND AIMS:
In the last few years numerous new P-CAB based RCTs concerning first-line regimens for H. pylori infection treatment from various countries have been published. However, no NWM exists which examines the comparative efficacy and safety of P-CAB based dual, triple and quadruple treatments and therefore, in this network meta-analysis (NWM) we examined this matter comparing efficacy and safety of these P-CAB based regimens.METHODS:
Databases were searched for identification, screening, eligibility and inclusion of relevant randomized controlled trials (RCTs). Extracted data were entered into a Bayesian NWM and the ranking order for each regimen was evaluated by means of surfaces under cumulative ranking area (SUCRA) values.RESULTS:
Twenty-five eligible RCTs were included with 7,605 patients randomized to 6 first line regimens, i.e. PCAB-DUAL, PCAB-TRIPLE, PCAB-QUADRUPLE, PPI-DUAL, PPI-TRIPLE, and PPI- QUADRUPLE. The SUCRA values (%) for these 6 regimens were 92.7, 62.5, 33.9, 75.1, 19.4 and 16.3 respectively. The comparative effectiveness ranking showed that PCAB-DUAL regimen ranked first for efficacy and last for adverse effects and had the best profile for integrated efficacy-safety.CONCLUSIONS:
In this NWM concerning the comparative efficacy and safety of P-CAB based dual, triple and quadruple regimens for first line H. pylori infection treatment, the overall results showed that PCAB based dual treatment ranked first for efficacy with the best-integrated efficacy-safety profile. This is of importance, since the dual regimens overcome the crucial issue of clarithromycin resistance. Consequently, these findings are expected to be useful in helping clinical decision-making and future guidelines.
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Base de dados:
MEDLINE
Idioma:
En
Revista:
Am J Gastroenterol
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Grécia