Meta-analysis of the efficacy of probiotics inHelicobacter pylorieradication therapy

Abstract

AIM:To evaluate the role of probiotics in the standard triple Helicobacter pylori therapy. METHODS:In this meta-analysis, we investigated the efficacy of probiotics in a standard triple H. pylori therapy in adults. Searches were mainly conducted in MEDLINE/PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials. Fourteen studies met our criteria, and the quality of these studies was assessed using the Jadad scale. We used STATA version 12.0 to extract data and to calculate the odds ratios (ORs), which are presented with the corresponding 95% confidence intervals (CIs). The data are presented as forest plots. RESULTS:The pooled ORs for the eradication rates calculated by intention-to-treat analysis and perprotocol analysis in the probiotic group vs the control group were 1.67 (95%CI: 1.38-2.02) and 1.68 (95%CI: 1.35-2.08), respectively, using the fixed-effects model. The sensitivity of the Asian studies was greater than that of the Caucasian studies (Asian: OR = 1.78, 95%CI: 1.40-2.26; Caucasian: OR = 1.48, 95%CI: 1.06-2.05). The pooled OR for the incidence of total adverse effects was significantly lower in the probiotic group (OR = 0.49, 95%CI: 0.26-0.94), using the random effects model, with significant heterogeneity (I 2 = 85.7%). The incidence of diarrhea was significantly reduced in the probiotic group (OR = 0.21, 95%CI: 0.06-0.74), whereas the incidence of taste disorders, metallic taste, vomiting, nausea, and epigastric pain did not differ significantly between the probiotic group and the control group. CONCLUSION:Supplementary probiotic preparations during standard triple H. pylori therapy may improve the eradication rate, particularly in Asian patients, and the incidence of total adverse effects. and rational search strategy, inclusion criteria, and statistical analyses, we found that supplementary probiotic preparations given during standard triple H. pylori therapy conferred a higher eradication rate, particularly in Asian patients, and a lower incidence of total adverse effects, particularly diarrhea. META-ANALYSIS

Antibiotic treatment forHelicobacter pylori: Is the end coming?

“…In a study by Lv et al [127] , the cure rates in the probiotic supplementation group were superior to those in the group that did not receive probiotics (RR, 1.12; 95%CI: 1.06-1.19), and probiotics reduced the risk of H. pylori therapy related side effects (RR, 0.60; 95%CI: 0.40-0.91). In another meta-analysis, the pooled odd ratios (ORs) for the eradication rate were higher in the probiotic group than the control group (OR = 1.67; 95%CI: 1.38-2.02) by ITT, and adverse effects were lower in the probiotic group (OR = 0.49, 95%CI: 0.26-0.94) [128] . This study also showed racial differences in the sensitivity to probiotics, with greater differences in Asian populations compared to Caucasians.…”

Practical Aspects in Choosing a Helicobacter pylori Therapy

“…70,71 Now 10 meta-analyses have been published addressing the specific benefit of Lactobacillus and Bifidobacterium, 72,73 bovine lactoferrin, 74,75 fermented milk-based, 76 Lactobacillus, 77,78 and Saccharomyces boulardii 79 probiotic formulations as well as probiotics as a whole therapeutic group. [80][81][82] Available evidence collectively points toward a benefit of using probiotic for decreasing antibioticrelated side effects and, to a much lesser extent, increasing cure rates.…”

Gastric Cancer Risk in Patients with Helicobacter pylori Infection and Following Its Eradication

“…10 Although primary intervention strategies basically rely on efforts to eradicate the bacteria, the best approach to eradication therapy has been, and continues to be, under debate (also in view of the emergence of antibiotic-resistant H pylori strains). [11][12][13][14][15][16] GASTRIC CANCER RISK: THE ASSESSMENT GC risk can be assessed using both noninvasive and invasive methods.…”