A 10- or 14-day Bismuth-containing Quadruple Therapy as a First-line Helicobacter pylori Eradication Therapy: A Systematic Review and Meta-analysis
- Author:
Sung Eun KIM
1
;
Hye-Kyung JUNG
;
Seung Joo KANG
;
Yong Chan LEE
;
Hyo-Joon YANG
;
Seon-Young PARK
;
Cheol Min SHIN
;
Hyun Chul LIM
;
Jie-Hyun KIM
;
Su Youn NAM
;
Woon Geon SHIN
;
Jae Myung PARK
;
Il Ju CHOI
;
Jae Gyu KIM
;
Miyoung CHOI
;
Author Information
- Publication Type:Original Article
- From:The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2021;21(1):48-58
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background/Aims:The eradication rate of the first-line standard triple therapy (STT) for Helicobacter pylori (H. pylori) infection has decreased since 2000; therefore, other first-line therapies are required. This study was aimed at investigating the efficacy of bismuth-containing quadruple therapy (PBMT) for first-line H. pylori eradication compared to STT, sequential therapy (SQT), and concomitant therapy (CT).
Materials and Methods:The Ovid-MEDLINE, Koreamed, EMBASE, KMBASE, and Cochrane Library databases were searched from January 2008 to July 2018. All identified randomized controlled trials (RCTs) comparing PBMT and non-PBMT for first-line H. pylori eradication therapy were included in the final analysis.
Results:A total of 3,653 patients from seven RCTs were enrolled. The pooled eradication rates of PBMT by intention-to-treat (ITT) and per-protocol (PP) analyses were 82.1% (95% CI, 68.2~90.8%) and 88.8% (95% CI, 77.1~94.9%), respectively. However, no statistically significant difference was observed in eradication rates of the 10- or 14-day PBMT as compared to 14-day STT, 10-day SQT, and 10-day CT in ITT and PP analyses. PBMT was significantly higher in adverse events than in the other eradication regimens (RR, 1.64; 95% CI, 1.11~2.44). Considerable heterogeneity in adverse events was observed among studies (χ2=88.7; P<0.001, I2=93%).
Conclusions:PBMT can be the first-line treatment for H. pylori eradication in Korea when other first-line options, including STT, SQT, or CT, are unavailable due to their high adverse event rates.
