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Standard Bismuth Quadruple Therapy versus Concomitant Therapy for the First-Line Treatment of Helicobacter pylori Infection: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Authors :
Rocco Maurizio Zagari
Elton Dajti
Anna Cominardi
Leonardo Frazzoni
Lorenzo Fuccio
Leonardo Henry Eusebi
Amanda Vestito
Andrea Lisotti
Giuseppe Galloro
Marco Romano
Franco Bazzoli
Zagari, Rocco Maurizio
Dajti, Elton
Cominardi, Anna
Frazzoni, Leonardo
Fuccio, Lorenzo
Eusebi, Leonardo Henry
Vestito, Amanda
Lisotti, Andrea
Galloro, Giuseppe
Romano, Marco
Bazzoli, Franco
Source :
Journal of Clinical Medicine. 12:3258
Publication Year :
2023
Publisher :
MDPI AG, 2023.

Abstract

(1) Background: Whether standard bismuth quadruple therapy (BQT) is superior to concomitant therapy for the first-line treatment of Helicobacter (H.) pylori infection is unclear. The aim of this systematic review and meta-analysis was to compare the efficacy of standard BQT versus concomitant therapy for H. pylori eradication in subjects naïve to treatment. (2) Methods: Online databases were searched for randomized controlled trials. We pooled risk ratio (RR) of individual studies for dichotomous outcomes using a random-effect model. (3) Results: Six studies with 1810 adults were included. Overall intention-to-treat (ITT) eradication rate was 87.4% with BQT and 85.2% with concomitant therapy (RR 1.01, 95%CI:0.94–1.07). Subgroup analysis of five Asian studies showed a small but significant superiority of BQT over concomitant therapy (87.5% vs. 84.5%; RR 1.04, 95%CI:1.01–1.08). Pooling four studies at low risk of bias yielded a similar result (88.2% vs. 84.5%; RR 1.05, 95%CI:1.01–1.09). There was no difference between the regimens in the frequency of adverse events (RR = 0.97, 95%CI:0.79–1.2). (4) Conclusions: The efficacy of BQT seems to be similar to concomitant therapy, with similar side effect profile. However, BQT showed a small but significant benefit over concomitant therapy in Asian populations and in studies at low risk of bias.

Details

ISSN :
20770383
Volume :
12
Database :
OpenAIRE
Journal :
Journal of Clinical Medicine
Accession number :
edsair.doi.dedup.....964ea663493e265d34248b96e0d6286d