Safety of furazolidone-containing regimen in Helicobacter pylori infection: a systematic review and meta-analysis

Abstract

ObjectivesFurazolidone containing regimen is effectivefor Helicobacter pylori (H. pylori) infection, but its safetyremains controversial. To assess the safety of furazolidone containing regimenin H. pylori infection.DesignA systematic review and meta-analysis.Data sourcesPubMed, Embase, Cochrane Library, Web of Science and Scopus databases were systematically searched for eligible randomised controlled trials.Eligibility criteriaStudies comparing furazolidone with non-furazolidone-containing regimen, variable durations or doses of furazolidone were included.Data extraction and synthesisTwo reviewers independently selected studies and extracted data. Primary outcomes were the risk of total adverse events (AEs), serious AEs and severe AEs, expressed as relative risk (RR) with 95% CI. Secondary outcomes contained the incidence of individual adverse symptoms, AE-related treatment discontinuation and compliance.ResultsTwenty-six articles were identified from 2039 searched records, of which 14 studies (n=2540) compared furazolidone with other antibiotics. The eradication rates of furazolidone-containing regimen were higher than those of other antibiotics in both intention-to-treat (RR 1.06, 95% CI 1.01 to 1.12) and per-protocol analysis (RR 1.05, 95% CI 1.00 to 1.10). Only two serious AEs were reported in furazolidone group (2/1221, 0.16%). No significant increased risk was observed for the incidence of total AEs (RR 1.04, 95% CI 0.89 to 1.21) and severe AEs (RR 1.81, 95% CI 0.91 to 3.60). Twelve studies (n=3139) compared different durations of furazolidone, and four studies (n=343) assessed variable doses. Elevated risk of total AEs and severe AEs were only found in a high daily dose of furazolidone rather than prolonged duration. The incidence of AE-related treatment discontinuation and compliance of patients were all similar, irrespective of dose and duration adjustments.ConclusionFurazolidone-containing regimen has a similar risk of AEs and compliance as non-furazolidone-containing regimen. A low daily dose of 200 mg is well-tolerated for 14 day regimen and should be first considered.PROSPERO registration numberCRD42019137247

Effect and Safety of Helicobacter pylori Eradication Treatment Based on Molecular Pathologic Antibiotic Resistance in Chinese Elderly People

“…FZD was fit for empirical therapy because the resistance rate was very low in our country. 19 , 20 There were 358 people subjected to bismuth quadruple therapy for fourteen days because six people were resistant to all available antibiotics. The PPIs in standard doses were used and the two antibiotics were determined by the molecular pathologic antibiotic resistance.…”

Effectiveness and Safety of Rifaximin-Containing Regimens for Helicobacter pylori Eradication: Systematic Review – Are They Potential Eradication Regimens?

“…Helicobacter pylori ( H. pylori ), affecting about 44.3% of the world’s population, 1 has become a major global public health problem threatened people globally, since it can pose a risk of peptic ulcers, gastric cancer, dyspepsia and other digestive diseases. 2 In recent decades, international guidelines and clinical practices have agreed on the active treatment of H. pylori and achieving desired eradication rate as an effective way to cure these diseases and preventing them from progressing to gastric cancer.…”

Short-term outcomes and intermediate-term follow-up ofHelicobacter pyloriinfection treatment for naïve patients: a retrospective observational study

“…29 According to a meta-analysis, a 14-day furazolidone-containing regimen with a low daily dose of 200 mg was well-tolerated and should be used as first-line treatment. 30 No serious adverse events were Open access reported among the cases in our study. Furazolidonecontaining therapies with a high eradication rate should be re-evaluated in other countries.…”

“…The Shire company stopped marketing furazolidone, and eventually withdrew it because of poor sales 29. According to a meta-analysis, a 14-day furazolidone-containing regimen with a low daily dose of 200 mg was well-tolerated and should be used as first-line treatment 30. No serious adverse events were reported among the cases in our study.…”