Pooled Analysis on the Efficacy of the Second-line Treatment Regimens for Helicobacter pylori Infection

Hojo, Mariko; Miwa, Hiroto; Nagahara, Akihito; Sato, Nobuhiro

doi:10.1080/003655201300191941

Cited by 99 publications

(74 citation statements)

References 37 publications

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“…[1][2][3]95 Here, quadruple therapy is recommended, although the second eradication may also fail in up to 30-40% of the cases as was shown by expert opinion, 96 a systematic review 97 and our own experience. 78 F-based second-line therapies obtained eradication rates as high as the primary regimens, suggesting that this compound could be usefully included in the second-line combinations.…”

Section: Discussionmentioning

confidence: 99%

Nitrofuran‐based regimens for the eradication of Helicobacter pylori infection

Buzás¹,

Józan

2007

J of Gastro and Hepatol

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Several aspects of Helicobacter pylori eradication have been meta-analyzed; however, nitrofuran-based therapies constitute an exception. The aim of this study was the systematic review and meta-analysis of the effect of furazolidone-and nitrofurantoin-based regimens in the eradication of infection. Studies evaluating the effects of nitrofurans on H. pylori were identified from Medline, EMBASE, the Cochrane Controlled Trials Register and congress abstracts. The studies were classified into groups based on first-, second-and third-line regimens. The pooled eradication rates and combined odd ratios of the individual studies were calculated and compared with the published meta-analysis. The factors influencing the efficiency of the regimens were also analyzed. Side-effects of nitrofuranbased regimens were also analyzed. The pooled eradication rate of primary proton pump inhibitor-based regimens containing furazolidone was 76.3% .2). The odds ratio for furazolidone-based regimens versus standard triple therapies was 2.34 (CI 0.76-3.92). Ranitidine bismuth citrate + furazolidone-based triple regimens were equally efficient (83.5%, CI 74.0-93.0, P = 0.06 versus triple therapies). Schedules including a H2 antagonist + furazolidone + one other antibiotic achieved pooled eradication rates of 79.9% (CI 67.8-89.9, P = 0.04). Bismuth-based triple therapies achieved 84.5% (CI 72.6-93.0, P = 0.002). Primary quadruple regimens containing furazolidone were superior to triple therapies (83.4%, CI 69.7-92.3, P = 0.01). Second-line schedules containing furazolidone obtained eradication rates of 76.1% (CI 66.4-85.0, P = 0.28 versus primary regimens). Third-line 'rescue' therapies were efficient in 65.5% of the cases (CI 56.3-75.5, P = 0.0001). Side-effects of the regimens containing furazolidone were more frequent than in standard therapies (P = 0.02). The combined odds ratio of side-effects for furazolidonebased versus standard therapies was 0.74 (CI 0.32-1.98). The duration of treatment, but not the furazolidone dose, influenced the treatment outcome. Primary triple regimens containing furazolidone are slightly less efficient than the standard primary combinations; primary quadruple regimens were more efficient than triple therapies. Furazolidone is also efficient as a component of second-line or rescue therapies.

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Section: Discussionmentioning

confidence: 99%

Nitrofuran‐based regimens for the eradication of Helicobacter pylori infection

Buzás¹,

Józan

2007

J of Gastro and Hepatol

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“…A meta-analysis of the efficacy of second-line H. pylori eradication regimens by Hojo et al 17 concluded that ranitidine-bismuth-based triple and quadruple therapies appeared to be the most effective second-line options. Therapies containing bismuth are not available for use in Japan, however, and the only authorized re-treatment regimens comprise PPI + AMPC + CAM (PPI/AC).…”

Section: Discussionmentioning

confidence: 99%

Comparison of efficacies of dual therapy and triple therapy using rabeprazole in second‐line eradication of Helicobacter pylori in Japan

Kawai

Kawakami

Kataoka

et al. 2006

Aliment Pharmacol Ther

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“…La eficacia de esos tratamientos ha disminuido conforme ha aparecido resistencia de H.pylori a los diferentes antibióticos 7 , de modo que actualmente alrededor del 20% de los pacientes no consiguen la erradicación tras el manejo inicial y de ellos, alrededor del 24 al 30% continúan sin conseguirla tras un segundo manejo 9,10 . Teniendo en cuenta la participación definida de H. pylori en las patologías graves mencionadas, así como el impacto que podría tener la utilización de antibióticos sobre la microbiota intestinal, la vacunación es una estrategia necesaria, que además puede prevenir posibles reinfecciones que hasta el momento no son evitables con las terapias de erradicación 11 , por lo que sería una solución para las consecuencias en la salud pública mundial que ha generado esta bacteria.…”

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