Cure of <i>Helicobacter pylori</i> infection does not improve symptoms in non‐ulcer dyspepsia patients—a double‐blind placebo‐controlled study

Miwa, Hiroto; Hirai, Shu; Nagahara, Akihito; Murai, Toshio; Nishira, Teruo; Kikuchi, Shogo; Takei, Yoshiyuki; Watanabe, Sumio; Sato, Nobuhiro

doi:10.1046/j.1365-2036.2000.00706.x

Cited by 93 publications

(94 citation statements)

References 28 publications

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“…Though, meta-analyses [12,13] has already concluded H. pylori treatment was succeed in halting progression of PL, we believe the retrospective design and inconsistent definitions of PL progression utilized might have a large extent influence to the pooled results. This is why most of previous RCTs assigned a single pathologist to evaluate the individual histological changes before and after eradication [1,2,31,34,37,38].Therefore, to make a more reliable investigation, we performed an analysis only included RCTs with individual histological change provided and further conducted subgroup analyses based on the definition of PL progression (histological step or histological score).In our results, the halt effect was more obviously observed in studies applied histological score comparison with studies compared histological step. Additional, in studies used a histological step comparison, eradication seems to promote the deterioration in those with a baseline diagnosis CIM.…”

Section: Discussionmentioning

confidence: 83%

“…Prospective studies, especially RCTs, which regarded the occurrence of GC as primary outcome were few, because the gastric carcinogenesis was time-consuming process which need long-term follow-up. Instead, based on the theory of consecutive progression process, many prospective studies evaluated the effect of H. pylori treatment in the PL to indirectly reflect the GC preventive effect [2,[29][30][31][32][33][34][35][36]. Though, meta-analyses [12,13] has already concluded H. pylori treatment was succeed in halting progression of PL, we believe the retrospective design and inconsistent definitions of PL progression utilized might have a large extent influence to the pooled results.…”

Section: Discussionmentioning

confidence: 99%

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Helicobacter pylori eradication cannot reduce the risk of gastric cancer in patients with intestinal metaplasia and dysplasia: evidence from a meta-analysis

et al. 2015

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Background The effect of Helicobacter pylori (H. pylori) eradication on gastric cancer (GC) prevention is controversial. Intestinal metaplasia (IM) seems to be a ''point of no return'' in the precancerous cascade. We performed a meta-analysis of randomized controlled trials (RCTs) to illustrate this issue. Materials and Methods The MEDLINE, EMBASE, Cochrane Library were searched for relevant RCTs that were published in any language up to March 2014. By dividing participants into subgroups based on their baseline diagnoses as group \IM (normal, non-atrophic gastritis, atrophic gastritis) and group CIM(intestinal metaplasia, dysplasia), the relative risk (RR) of GC in each study compared treatment group with control group were pooled using Mantel-Haenszel fixed-effect model and publication bias analyses were performed.Results Ten studies from eight RCTs were included in this analysis, for a total of 7,955 participants. H. pylori treatment compared with control significantly reduced the risk of GC, with a pooled RR of 0.64 (95 % CI, 0.48-0.85). Subgroup analysis for patients with non-atrophic gastritis, atrophic gastritis (\IM) yielded a similar results (RR = 0.25, 95 % CI, 0.08-0.81). But this difference was not observed in patients with intestinal metaplasia, dysplasia (CIM) (RR = 0.88; 95 % CI, 0.59-1.31). Conclusions Our results suggested that patients with Intestinal metaplasia or dysplasia could not benefit from the H. pylori treatment on the risk of GC.

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Helicobacter pylori eradication cannot reduce the risk of gastric cancer in patients with intestinal metaplasia and dysplasia: evidence from a meta-analysis

et al. 2015

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“…Agents with property of opioid agonists or serotonin type-3 receptor antagonists are considered to diminish visceral hypersensitivity, and Helicobacter pylori infection eradication therapy has also been considered, although the usefulness of these therapies has not been confirmed and mostly a combination of above is required to tackle the condition [17,18].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Tolerability of Levosulipride, Domperidone and Metoclopramide in Patients with Non-Ulcer Functional Dyspepsia: A Comparative Analysis

Singh

Bala

Kaur

2015

JCDR

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“…This trial evaluated 84 patients and reported no change in mean dyspepsia score between those randomised to H. pylori eradication therapy and placebo. Nine trials, 207,208,210,212,214,[216][217][218][219] evaluating a total of 2541 patients, reported dyspepsia as a dichotomous outcome at 6 months or 1 year (Figure 18 ). Three trials 207,208,212 reported continuous data for 848 patients at 1 year ( Figure 19 ).…”

Section: Results Of the Review The Effect Of H Pylori Eradication Onmentioning

confidence: 99%

The management of dyspepsia: a systematic review.

Delaney

Moayyedi²,

Deeks³

et al. 2000

Health Technology Assessment

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Cure of Helicobacter pylori infection does not improve symptoms in non‐ulcer dyspepsia patients—a double‐blind placebo‐controlled study

Abstract: Although histological parameters were significantly improved in the treatment group, there was no significant improvement in symptoms of NUD in the treatment group compared to placebo.

Cited by 93 publications

References 28 publications

Helicobacter pylori eradication cannot reduce the risk of gastric cancer in patients with intestinal metaplasia and dysplasia: evidence from a meta-analysis

Helicobacter pylori eradication cannot reduce the risk of gastric cancer in patients with intestinal metaplasia and dysplasia: evidence from a meta-analysis

Efficacy and Tolerability of Levosulipride, Domperidone and Metoclopramide in Patients with Non-Ulcer Functional Dyspepsia: A Comparative Analysis

The management of dyspepsia: a systematic review.

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