A meta‐analysis comparing eradication, healing and relapse rates in patients with Helicobacter pylori‐associated gastric or duodenal ulcer

Abstract

Aim: To compare the effectiveness of Helicobacter pylori eradication in curing peptic ulcer disease in trials involving both gastric ulcer and duodenal ulcer. Methods: Twenty‐four relevant randomized controlled trials and randomized comparative trials met the predefined selection criteria. Only proton pump inhibitor‐based eradication trials were considered for the evaluation of eradication efficacy and ulcer healing. For the determination of relapse rates, all trials independent of the eradication therapy regimen were considered. Results: Data from 2102 patients were analysed comparing gastric ulcer with duodenal ulcer. No statistical differences between gastric ulcer and duodenal ulcer patients were found with regard to eradication rates (summarized odds ratio, 1.23; 95% confidence interval, 0.98–1.55) or ulcer relapse rates, whether in successfully H. pylori eradicated patients (summarized odds ratio, 0.69; 95% confidence interval, 0.26–1.84) or unsuccessfully H. pylori eradicated patients (summarized odds ratio, 1.48; 95% confidence interval, 0.85–2.56). Owing to heterogeneity, healing rates were not comparable. Conclusions: The eradication of H. pylori infection cures both gastric and duodenal ulcer, and the cure rates are similar. This suggests that H. pylori is the key factor in peptic ulcer disease independent of the ulcer site.

A Multicenter Prospective Observational Study of Triple Therapy with Rabeprazole, Amoxicillin and Metronidazole for <i>Helicobacter pylori</i> in Japan

“…pylori eradication therapy is effective for accelerating healing and inhibiting the recurrence of gastric and duodenal ulcers (2,3) and is recommended in various guidelines as a first-line therapy for H. pylori-positive gastric and duodenal ulcers (1,4,5). In Japan, triple therapy with a proton pump inhibitor (PPI) and two different antimicrobial agents has been approved for H. pylori eradication.…”

A win for the patient: Direct patient notification significantly improves treatment rates of active Helicobacter pylori infection

“…1,2 For the individual patient, the benefits of H. pylori treatment include proven promotion of ulcer healing, reduction in ulcer recurrence, and reduced incidence of malignancy. 5,6 The most commonly used firstline eradication regimen is the ubiquitous triple therapy consisting of a proton pump inhibitor, amoxicillin (or metronidazole for penicillin-allergic patients), and clarithromycin for a total of 7-14 days. 7 In New Zealand, rapid urease testing using the CLO test is the standard diagnostic modality used for the detection of active H. pylori infection during endoscopy.…”

Review: Eradication of Helicobacter pylori to prevent gastroduodenal diseases: Hitting more than one bird with the same stone

“…Eradication of H. pylori also promotes duodenal ulcer healing, as compared to ulcer healing drug (RR ¼ 0.66; 95% CI ¼ 0.58 to 0.76) and no treatment (RR ¼ 0.37; 95% CI 0.26 to 0.53) [Ford et al 2006]. Several health economic models also suggest that H. pylori eradication is costeffective in reducing the recurrence of peptic ulcer disease [Ford et al 2004;Ofman et al 2002;Leodolter et al 2001;Imperiale et al 1995]. Imperiale et al showed that initial H. pylori eradication provides the lowest costs per symptomatic cure and was associated with lower recurrence rates than initial treatment with an H2-receptor antagonist [Imperiale et al 1995].…”

“…Imperiale et al showed that initial H. pylori eradication provides the lowest costs per symptomatic cure and was associated with lower recurrence rates than initial treatment with an H2-receptor antagonist [Imperiale et al 1995]. Leodolter et al compared the eradication, healing, and relapse rates in patients with H. pylori-associated gastric or duodenal ulcer and concluded that the cure rates are similar for both gastric and duodenal ulcer [Leodolter et al 2001]. In a Markov model, Ford et al found H. pylori eradication is cost-effective for duodenal ulcer over one year and gastric ulcer over two years [Ford et al 2004].…”