A 10- or 14-day Bismuth-containing Quadruple Therapy as a First-line Helicobacter pylori Eradication Therapy: A Systematic Review and Meta-analysisopen access
- Authors
- Kim, Sung Eun; Jung, Hye-Kyung; Kang, Seung Joo; Lee, Yong Chan; Yang, Hyo-Joon; Park, Seon-Young; Shin, Cheol Min; Lim, Hyun Chul; Kim, Jie-Hyun; Nam, Su Youn; Shin, Woon Geon; Park, Jae Myung; Choi, Il Ju; Kim, Jae Gyu; Choi, Miyoung
- Issue Date
- Mar-2021
- Publisher
- 대한상부위장관ㆍ헬리코박터학회
- Keywords
- Adverse effects; Bismuth tripotassium dicitrate; Disease eradication; Helicobacter pylori; Meta-analysis
- Citation
- Korean Journal of Helicobacter Upper Gastrointestinal Research, v.21, no.1, pp 48 - 58
- Pages
- 11
- Journal Title
- Korean Journal of Helicobacter Upper Gastrointestinal Research
- Volume
- 21
- Number
- 1
- Start Page
- 48
- End Page
- 58
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/48725
- DOI
- 10.7704/kjhugr.2020.0052
- ISSN
- 1738-3331
2671-826X
- Abstract
- Background/Aims: The eradication rate of the first-line standard triple therapy (STT) for Helicobacter pylori (H. pylori) infection has decreased since 2000; therefore, other first-line therapies are required. This study was aimed at investigating the efficacy of bismuth- containing quadruple therapy (PBMT) for first-line H. pylori eradication compared to STT, sequential therapy (SQT), and concomitant therapy (CT).
Materials and Methods: The Ovid-MEDLINE, Koreamed, EMBASE, KMBASE, and Cochrane Library databases were searched from January 2008 to July 2018. All identified randomized controlled trials (RCTs) comparing PBMT and non-PBMT for first-line H. pylori eradication therapy were included in the final analysis.
Results: A total of 3,653 patients from seven RCTs were enrolled. The pooled eradication rates of PBMT by intention-to-treat (ITT) and per-protocol (PP) analyses were 82.1% (95% CI, 68.2~90.8%) and 88.8% (95% CI, 77.1~94.9%), respectively. However, no statistically significant difference was observed in eradication rates of the 10- or 14-day PBMT as compared to 14-day STT, 10-day SQT, and 10-day CT in ITT and PP analyses. PBMT was significantly higher in adverse events than in the other eradication regimens (RR, 1.64; 95% CI, 1.11~2.44). Considerable heterogeneity in adverse events was observed among studies (χ2=88.7; P<0.001, I2=93%).
Conclusions: PBMT can be the first-line treatment for H. pylori eradication in Korea when other first-line options, including STT, SQT, or CT, are unavailable due to their high adverse event rates.
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