Failure of a 1‐day high‐dose quadruple therapy for cure of <i>Helicobacter pylori</i> infection

Wermeille,; Cunningham,; Armenian,; Zelger,; Buri,; Merki,; Hadengue,

doi:10.1046/j.1365-2036.1999.00447.x

Cited by 13 publications

(17 citation statements)

References 19 publications

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“…Eight were excluded from further analysis; [34][35][36][37][38][39][40][41] the reasons for exclusion are outlined in Table 1. All studies compared triple vs. quadruple therapy for H. pylori eradication.…”

Section: Resultsmentioning

confidence: 99%

Triple vs. quadruple therapy for treating Helicobacter pylori infection: an updated meta‐analysis

Gené

Calvet

Azagra

et al. 2003

Aliment Pharmacol Ther

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Triple vs. quadruple therapy for treating Helicobacter pylori infection: an updated meta-analysis Sirs, Since we submitted our paper, ÔTriple vs. quadruple therapy for treating Helicobacter pylori infection: a meta-analysisÕ, for publication in Alimentary Pharmacology and Therapeutics, 1 a new study comparing triple with quadruple therapy has been published. 2 Full-text reports of two of the studies included in the metaanalysis in abstract form have also been published. 3, 4The objective of this letter is to update the meta-analysis using these new results. whereas there are small differences between the abstract and full-text form of the paper by Laine et al. 4The results of our meta-analysis did not change after introducing these modifications ( Figure 1). In the intention-to-treat analysis, eradication was achieved in 449 of 559 patients with quadruple therapy [80%; 95% confidence interval (CI), 77-84%] and in 451 of 569 patients with triple therapy (79%; 95% CI, 74-81%). The odds ratio (Figure 1) was 1.00 (95% CI, 0.64-1.57; P ¼ 1). In the per protocol analysis, eradication was achieved in 421 of 486 patients with quadruple therapy (87%; 95% CI, 84.1-90.5%) and in 435 of 509 patients with triple therapy (85%; 95% CI, 81.4-88.3%). The odds ratio was 0.95 (95% CI, 0.58-1.57; P ¼ 0.9).In conclusion, the update of our meta-analysis suggests that the conclusions of the previous report can be maintained, and that the effectiveness of quadruple and triple therapy is very similar for the initial treatment of H. pylori infection.E. Gené *, X. Calvet , R.

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Section: Resultsmentioning

confidence: 99%

Triple vs. quadruple therapy for treating Helicobacter pylori infection: an updated meta‐analysis

Gené

Calvet

Azagra

et al. 2003

Aliment Pharmacol Ther

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“…Among these studies, 7-day PPI plus standard bismuth triple therapy, which is now termed quadruple therapy , provides a consistently high eradication rate (approximately 96%) [10,16]. Several short-duration regimens for cure of H. pylori infection have been reported [2,3,[18][19][20][21][22][23][24]. Furthermore, this therapy has fewer adverse effects than commonly observed with 14-day bismuth triple therapy [17].…”

Section: Discussionmentioning

confidence: 99%

Addition of Metronidazole to Rabeprazole‐Amoxicillin‐Clarithromycin Regimen for Helicobacter pylori Infection Provides an Excellent Cure Rate with Five‐Day Therapy

et al. 2000

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“…It was unclear in some of the included studies whether the patients were H. pylori treatment-naive, which might have affected responses to the protocols (Moshkowitz et al, 1999). In addition, some sample sizes were too small to be persuasive (Wermeille et al, 1999;Huo et al, 2006). It was reported that randomization with an adequate number of subjects increases the likelihood that groups will have similar background risks (Fischbach et al, 2002).…”

Section: Discussionmentioning

confidence: 99%

“…If a higher frequency of re-infection is encountered in the long term, the primary scheme should seriously be questioned, and a more suitable approach with persistent H. pylori eradication is preferred. Some trials had extremely low eradication rates with standard 7-d triple protocols (Wermeille et al, 1999;Zhang et al, 2006).…”

Section: Discussionmentioning

confidence: 99%

“…We also performed sensitivity analysis by excluding those with less than 40 cases in each group (Pieramico et al, 1998;Wermeille et al, 1999;Yang et al, 2003;Zheng et al, 2005;Huo et al, 2006), and the models did not notably change from the overall results. Pooled RRs of ITT and PP were 0.88 (95% CI: 0.76-1.02) and 0.89 (95% CI: 0.78-1.03), respectively.…”

Section: )mentioning

confidence: 99%

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Is short-term therapy really sufficient to eradicate Helicobacter pylori infection?

Zhou

Chen

Zhang

et al. 2010

J. Zhejiang Univ. Sci. B

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Abstract:Objective: The aim of our study was to perform a systematic review and meta-analysis of the efficacy of short-term protocols for Helicobacter pylori eradication and to review the safety and adverse profiles of these eradication protocols. Methods: Literatures were located through electronic searches by PubMed, Medline, ISI Web of Knowledge, and Cochrane Library using the relevant terms. Abstracts of important meetings were searched manually in some journal supplements. Additional bibliographies were identified from the reference lists of identified studies. Three independent reviewers systemically identified randomized controlled trials (RCTs) comparing short-duration protocols vs. 7-d proton pump inhibitor (PPI)-based triple protocols, as well as studies reporting eradication rates of short-duration protocols for H. pylori. Summary effect size was calculated as relative risk (RR) and 95% confidence intervals (CI) using Review Manager 4.2, and P<0.05 was defined as statistically significant in all analyses. Results: Among 90 abstracts retrieved, 15 studies were analyzed, including a total of 30 treatment regimens with 1856 subjects. Mean intention-to-treat (ITT) cure rates of 63.2% and 81.3% were achieved with short-term protocols and 7-d PPI-containing protocols, respectively. Per-protocol (PP)-based overall cure rates were 66.6% and 86.1%, respectively. Short-term therapy was inferior to 7-d triple regimen (P<0.00001). After sub-analysis, however, comparing the effects of ≥3-d protocols and 7-d triple protocols, the cumulative ITT RR was 0.95 (P=0.26), and PP RR was 0.95 (P=0.10), without significant heterogeneity. Moreover, slightly fewer adverse-effects were found in short-term protocols. Conclusions: Although more economical, short-duration protocols are inferior to 7-d PPI-based triple protocols with regarding to eradication rate of H. pylori. Protocols of more than 3 d, however, may be equivalent to 7-d protocols.

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Failure of a 1‐day high‐dose quadruple therapy for cure of Helicobacter pylori infection

Abstract: There is at present clear evidence that Helicobacter pylori is the main aetiologic agent of most gastritis (type B gastritis) and peptic ulceration. Eradication of infection leads to resolution of the gastritis and to spectacular decreases of duodenal and gastric ulcer relapses.

Cited by 13 publications

References 19 publications

Triple vs. quadruple therapy for treating Helicobacter pylori infection: an updated meta‐analysis

Triple vs. quadruple therapy for treating Helicobacter pylori infection: an updated meta‐analysis

Addition of Metronidazole to Rabeprazole‐Amoxicillin‐Clarithromycin Regimen for Helicobacter pylori Infection Provides an Excellent Cure Rate with Five‐Day Therapy

Is short-term therapy really sufficient to eradicate Helicobacter pylori infection?

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