Sequential Therapy for Helicobacter pylori Infection in Korea: Systematic Review and Meta-Analysis
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Background/Aims: Sequential therapy (ST) for Helicobacter pylori infection in countries other than Korea has shown higher eradication rates than triple therapy (TT). The aim of this study was to evaluate the efficacy of ST in Korea by performing a meta-analysis. Methods: We performed a comprehensive literature search on the efficacy of ST as a first-line therapy. The odds ratios (ORs) of eradicating H. pylori infection after ST compared with TT were pooled. Pooled estimates of the eradication rates of ST and TT were also calculated. Results: A total of six studies provided data on 1,759 adult patients. The ORs for the intention to treat (ITT) and the perprotocol (PP) eradication rate were 1.761 (95% confidence interval [CI], 1.403 to 2.209) and 1.966 (95% CI, 1.489 to 2.595). Pooled estimates of the ITT and PP eradication rate were 79.4% (95% CI, 76.3% to 82.2%) and 86.4% (95% CI,83.5% to 88.8%), respectively, for the ST group, and 68.2%(95% CI, 62.1% to 73.8%) and 78.9% (95% CI, 68.9% to 81.7%), respectively, for the TT group. Conclusions: Although ST presented a higher eradication rate than TT in Korea, the pooled eradication rates were lower than expected. Further studies are needed to validate ST as a first-line treatment for H. pylori in Korea.
Abstract
Background/Aims: Sequential therapy (ST) for Helicobacter pylori infection in countries other than Korea has shown higher eradication rates than triple therapy (TT). The aim of this study was to evaluate the efficacy of ST in Korea by performing a meta-analysis. Methods: We performed a comprehensive literature search on the efficacy of ST as a first-line therapy. The odds ratios (ORs) of eradicating H. pylori infection after ST compared with TT were pooled. Pooled estimates of the eradication rates of ST and TT were also calculated. Results: A total of six studies provided data on 1,759 adult patients. The ORs for the intention to treat (ITT) and the perprotocol (PP) eradication rate were 1.761 (95% confidence interval [CI], 1.403 to 2.209) and 1.966 (95% CI, 1.489 to 2.595). Pooled estimates of the ITT and PP eradication rate were 79.4% (95% CI, 76.3% to 82.2%) and 86.4% (95% CI,83.5% to 88.8%), respectively, for the ST group, and 68.2%(95% CI, 62.1% to 73.8%) and 78.9% (95% CI, 68.9% to 81.7%), respectively, for the TT group. Conclusions: Although ST presented a higher eradication rate than TT in Korea, the pooled eradication rates were lower than expected. Further studies are needed to validate ST as a first-line treatment for H. pylori in Korea.
참고문헌 (22)
- Vakil N, "Eradication therapy for Helicobacter pylori", Gastroenterology, 133, pp.985~1001 (2007)
- Zullo A, "High eradication rates of Helicobacter pylori with a new sequential treatment", Aliment Pharmacol Ther, 17, pp.719~726 (2003)
- Zullo A, "The sequential therapy regimen for Helicobacter pylori eradication: a pooled-data analysis", Gut, 56, pp.1353~1357 (2007)
- Gatta L, "Sequential therapy or triple therapy for Helicobacter pylori infection: systematic review and meta-analysis of randomized controlled trials in adults and children", Am J Gastroenterol, 104, pp.3069~3079 (2009)
- Tong JL, "Sequential therapy vs. standard triple therapies for Helicobacter pylori infection: a meta-analysis", J Clin Pharm Ther, 34, pp.41~53 (2009)
- Jafri NS, "Meta-analysis: sequential therapy appears superior to standard therapy for Helicobacter pylori infection in patients naive to treatment", Ann Intern Med, 148, pp.923~931 (2008)
- Hwang TJ, "Change in antibiotic resistance of Helicobacter pylori strains and the effect of A2143G point mutation of 23S rRNA on the eradication of H. pylori in a single center of Korea", J Clin Gastroenterol, 44, pp.536~543 (2010)
- "Distribution of antibiotic MICs for Helicobacter pylori strains over a 16-year period in patients from Seoul, South Korea", Antimicrobial Agents and Chemotherapy, 48(12), pp.4843~4847 (2004), American Society for Microbiology
- Jadad AR, "Assessing the quality of reports of randomized clinical trials: is blinding necessary", Control Clin Trials, 17, pp.1~12 (1996)
- "Comparison of sequential and 7-, 10-, 14-d triple therapy for Helicobacter pylori infection", WORLD JOURNAL OF GASTROENTEROLOGY, 18(19), pp.2377~2382 (2012), BAISHIDENG PUBL GRP CO LTD
- "Ten-day sequential versus triple therapy for Helicobacter pylori eradication: A prospective, open-label, randomized trial", JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, 27(11), pp.1675~1680 (2012), WILEY-BLACKWELL
- Park HG, "Randomised clinical trial: a comparative study of 10-day sequential therapy with 7-day standard triple therapy for Helicobacter pylori infection in naive patients", Aliment Pharmacol Ther, 35, pp.56~65 (2012)
- "Randomised clinical trial: the efficacy of a 10-day sequential therapy vs. a 14-day standard proton pump inhibitor-based triple therapy for Helicobacter pylori in Korea", ALIMENTARY PHARMACOLOGY THERAPEUTICS, 34(9), pp.1098~1105 (2011), WILEY-BLACKWELL
- Oh HS, "Ten-day sequential therapy is more effective than proton pump inhibitor-based therapy in Korea: a prospective, randomized study", J Gastroenterol Hepatol, 27, pp.504~509 (2012)
- 최우혁, "Helicobacter pylori 감염 환자에서 10일 연속 제균치료의 효과", 대한소화기학회지, 51(5), pp.280~284 (2008), 대한소화기학회
- Malfertheiner P, "Current concepts in the management of Helicobacter pylori infection: the Maastricht III Consensus Report", Gut, 56, pp.772~781 (2007)
- Gisbert JP, "Proton pump inhibitor, clarithromycin and either amoxycillin or nitroimidazole: a meta-analysis of eradication of Helicobacter pylori", Aliment Pharmacol Ther, 14, pp.1319~1328 (2000)
- Fuccio L, "Meta-analysis: duration of first-line proton-pump inhibitor based triple therapy for Helicobacter pylori eradication", Ann Intern Med, 147, pp.553~562 (2007)
- Zullo A, "Standard triple and sequential therapies for Helicobacter pylori eradication: an update", Eur J Intern Med, 24, pp.16~19 (2013)
- Greenberg ER, "14-day triple, 5-day concomitant, and 10-day sequential therapies for Helicobacter pylori infection in seven Latin American sites: a randomised trial", Lancet, 378, pp.507~514 (2011)
- Liou JM, "Sequential versus triple therapy for the first-line treatment of Helicobacter pylori: a multicentre, open-label, randomised trial", Lancet, 381, pp.205~213 (2013)
- 김나영, "헬리코박터 파일로리 감염의 진단 및 치료 가이드라인", 대한소화기학회지, 54(5), pp.269~278 (2009), 대한소화기학회