A Meta-Analysis: Comparison of Esomeprazole and Other Proton Pump Inhibitors in Eradicating <i>Helicobacter pylori</i>

Abstract

Background: To assess effects of esomeprazole-based therapies and others (PPIs) on Helicobacter pylori eradication when co-administered with antibiotics. Goals: Using the terms ‘H. pylori eradication’ and ‘esomeprazole’, we searched Medline, Embase, and the Cochrane Library (2000–2005) and conducted a manual search of related Chinese journals to identify randomized controlled trials (RCTs) that compared the treatment effects of esomeprazole and other PPI therapies in patients with H. pylori infection. Results: Of the 75 articles screened, 11 RCTs including 2,159 subjects were included in the meta-analysis. The mean H. pylori eradication rates (intention-to-treat, ITT) with esomeprazole + antibiotics was 86%, a rate comparable with other PPI therapies, 81% (ITT); the odds ratio (OR) was 1.38 (95% CI = 1.09–1.75). A focused meta-analysis of 6 selected high-quality studies was produced an OR of this comparison that was closer to one (1.17, 95% CI = 0.89–1.54), with the results being statistically homogeneous. Sub-analysis that included only studies comparing different does of esomeprazole with omeprazole or pantoprazole did not reveal significant differences. No additional serious adverse events were reported. Conclusions: Esomeprazole-based triple therapy may effectively eradicate H. pylori infection and promote favorable outcome with good tolerance and offers comparable efficacy to omeprazole-based therapy.

Ideal treatment for Helicobacter pylori: A systematic review

“…However, in contrast, an additional systematic review favored the regimens based on esomeprazole. 91 Our results indicate that treatment duration above 7 days does not improve the effectiveness of the standard triple therapy, but this differs with the systematic review of Calvet et al; 94 they included 7 randomized clinical trials in their analysis and justify the use of 14-day therapies versus 7-day therapies. Nevertheless, in these 7 studies different therapeutic combinations were employed: PPI plus amoxicillin and clarithromycin, clarithromycin plus metronidazole or amoxicillin and clarithromycin and metronidazole.…”

Tratamiento ideal del Helicobacter pylori: una revisión sistemática

“…De manera adicional, según los hallazgos obtenidos en 4 revisiones sistemáticas 91-93 en las que se compararon regí-menes triples con diferentes inhibidores de la bomba de protones como tratamiento de primera línea, 3 de estos no mostraron una diferencia significativa en sus tasas de erradicación, lo cual guarda buena correspondencia con nuestra revisión. Sin embargo, de manera contraria, una revisión sistemática adicional favoreció los regímenes basados en esomeprazol 91 . Nuestros resultados indican que un tiempo mayor a 7 días no mejora la eficacia de la triple terapia estándar; sin embargo, lo anterior diverge con la revisión sistemática de Calvet et al 94 , quienes incluyeron en su análisis 7 ensayos clínicos aleatorizados, y justifican el uso de terapias de 14 días versus 7 días.…”

Double‐Dose, New‐Generation Proton Pump Inhibitors Do Not Improve Helicobacter pylori Eradication Rate

“…The eradication of bacterial infection offers effective cure and prevents these H. pylori ‐associated conditions [4–6]. The treatment of choice for H. pylori infection is triple therapy comprised of a proton pump inhibitor (PPI) and two antibiotics, and many studies have compared new‐generation PPIs with old‐generation PPIs, like omeprazole [7–10]. However, there are few studies comparing double‐dose new‐generation PPI with standard dose old‐generation PPI.…”