Dataset Information

High dose PPI-amoxicillin dual therapy for the treatment of Helicobacter pylori infection: a systematic review with meta-analysis.

ABSTRACT:

Background

Helicobacter pylori resistance to amoxicillin remains rare in many regions. Proton pump inhibitor-amoxicillin-containing high dose dual therapy (HDDT) has been proposed to treat H. pylori infection. We aimed to assess the effectiveness and safety of PPI-amoxicillin HDDT for treatment of H. pylori infection in comparison with other regimens.

Methods

Databases, including PubMed, Embase, and the Cochrane Register of Controlled Trials, were searched to find relevant publications. Randomized controlled trials comparing HDDT with control regimens for H. pylori eradication in adult patients were included. The primary outcome was eradication rate by intention-to-treat analysis. Adverse events were analyzed as second outcome.

Results

A total of 15 trials with 3818 patients qualified for inclusion. The eradication rate of HDDT was neither significantly inferior nor superior to the recommended regimens such as triple therapy, bismuth quadruple therapy, and non-bismuth quadruple therapy [relative risk (RR): 1.00, 95% confidence interval (CI): 0.96-1.05, p = 0.870]. This finding was robust through subgroup analyses and sensitivity analyses. Trial sequential analysis showed that HDDT was equivalent to control regimens, and further similar trials were unlikely to alter the conclusions of this analysis. The frequency of adverse events was significantly lower in HDDT group (RR: 0.48, 95% CI: 0.37-0.64, p < 0.001).

Conclusion

HDDT was equivalent to recommended first-line or rescue regimens with fewer adverse effects. The evidence from this meta-analysis supports the use of HDDT as first-line or rescue treatment for H. pylori infection.

Trial registration

PROSPERO CRD42019133002.

SUBMITTER: Zhu YJ

PROVIDER: S-EPMC7559363 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Publications

High dose PPI-amoxicillin dual therapy for the treatment of <i>Helicobacter pylori</i> infection: a systematic review with meta-analysis.

Zhu Yang-Jie YJ Zhang Yi Y Wang Ting-Yi TY Zhao Jing-Tao JT Zhao Zhe Z Zhu Jian-Ru JR Lan Chun-Hui CH

Therapeutic advances in gastroenterology 20200731

<h4>Background</h4><i>Helicobacter pylori</i> resistance to amoxicillin remains rare in many regions. Proton pump inhibitor-amoxicillin-containing high dose dual therapy (HDDT) has been proposed to treat <i>H. pylori</i> infection. We aimed to assess the effectiveness and safety of PPI-amoxicillin HDDT for treatment of <i>H. pylori</i> infection in comparison with other regimens.<h4>Methods</h4>Databases, including PubMed, Embase, and the Cochrane Register of Controlled Trials, were searched to ...[more]

PMID: 33110448

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