Systematic review with meta-analysis: 10- or 14-day sequential therapy vs. 14-day triple therapy in the first line treatment of Helicobacter pylori infection.
Aliment Pharmacol Ther
; 43(4): 470-81, 2016 Feb.
Article
en En
| MEDLINE
| ID: mdl-26669729
ABSTRACT
BACKGROUND:
Whether 10-day or 14-day sequential therapy is superior to 14-day triple therapy in the first-line treatment of Helicobacter pylori remains controversial.AIM:
To compare the efficacy of 10-day or 14-day sequential therapy vs. 14-day triple therapy.METHODS:
Randomised controlled trials (RCTs) comparing 10-day or 14-day sequential therapy and 14-day triple therapy as first-line treatment in adults were searched from the PubMed and Cochrane databases from 2000 to October 2015. Abstracts from international annual conferences were also searched. The primary and secondary outcomes were the eradication rate according to the intention-to-treat analysis and adverse effects, respectively.RESULTS:
Of the 109 articles identified, 13 RCTs including 2749 patients in the sequential therapy group and 2424 patients in the 14-day triple therapy group were eligible. Overall, sequential therapy for 10 or 14 days was not significantly superior to 14-day triple therapy [Risk ratio (RR) 1.04, 95% confidence interval (CI) 0.99-1.08, P = 0.145]. However, there was significant heterogeneity (I(2) = 57.6%, P = 0.005). In the subgroup analysis of four trials, we found that 14-day sequential therapy was significantly more effective than 14-day triple therapy (RR 1.09, 95% CI 1.04-1.16, P = 0.002), and there was no significant heterogeneity (I(2) = 0%, P = 0.624) in this comparison. Sequential therapy given for 10 days was not superior to 14-day triple therapy (RR 1.03, 95% CI 0.98-1.09, P = 0.207). There was no significant difference in the risk of adverse effects.CONCLUSION:
Sequential therapy given for 14 days, but not 10 days, was more effective than 14-day triple therapy as first-line treatment.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Helicobacter pylori
/
Infecciones por Helicobacter
/
Inhibidores de la Bomba de Protones
/
Antiinfecciosos
Tipo de estudio:
Clinical_trials
/
Systematic_reviews
Límite:
Adult
/
Humans
Idioma:
En
Revista:
Aliment Pharmacol Ther
Asunto de la revista:
FARMACOLOGIA
/
GASTROENTEROLOGIA
/
TERAPIA POR MEDICAMENTOS
Año:
2016
Tipo del documento:
Article
País de afiliación:
Taiwán