scholarly journals Effect of Statins on Helicobacter pylori Eradication Rate: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 1-9
Author(s):  
Mohsen Rajabnia ◽  
Amir Sadeghi ◽  
Saeed Abdi ◽  
Mihnea-Alexandru Găman ◽  
Mohammad Reza Zali ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Random Effects ◽  
Eradication Rate ◽  
Standard Treatment ◽  
Meta Analysis ◽  
Treatment Regimens ◽  
Randomized Controlled ◽  
Effect Measure ◽  
H Pylori ◽  
Meta Analyses

Statins have been used as adjuvants to standard treatment in order to increase the eradication rates<i></i>of<i> Helicobacter pylori</i> infection. This study aimed to summarize the results of the efficacy of adding statins to standard treatments used for the eradication<i></i>of<i> H. pylori</i> infection. We conducted a systematic search using a comprehensive combination of keywords in PubMed/MEDLINE, Web of Science, and Scopus to retrieve relevant studies from 1990 to 2020. The estimate of pooled relative risk (RR), as the effect measure, was calculated using random effects meta-analyses in Stata 14. We finally included 5 studies (all of them were randomized controlled trials). The meta-analysis of all studies showed that the pooled RR (95% confidence interval) was 1.03 (0.64–1.68) in the random effects model, which was not statistically significant. In other words, based on our meta-analysis, the addition of statins as an adjuvant therapy to the standard treatment regimens does not increase the rate of <i>H. pylori</i> eradication. However, further evidence is needed to confirm this result as the number of available studies was small.

scholarly journals The Effect of Helicobacter pylori Eradication on Lipid Levels: A Meta-Analysis

2021 ◽  
Vol 10 (5) ◽  
pp. 904
Author(s):  
Jun Watanabe ◽  
Masato Hamasaki ◽  
Kazuhiko Kotani
Keyword(s):  
Helicobacter Pylori ◽  
Cardiovascular Diseases ◽  
Meta Analysis ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Lipid Levels ◽  
Pubmed Database ◽  
H Pylori ◽  
Meta Analyses

Introduction: Helicobacter pylori (H. pylori) infection is positively associated with cardiovascular diseases, but the involvement of lipids in this association remains unclear. The present study reviewed the changes in circulating lipid levels following H. pylori eradication. Methods: A PubMed database was searched until December 2020 to identify randomized control trials (RCTs) and non-RCTs investigating the effect of H. pylori eradication on the lipid levels in inverse variance-weighted, random-effects meta-analyses. Results: A total of 24 studies (four RCTs and 20 non-RCTs) with 5270 participants were identified. The post-eradication levels were increased for high-density lipoprotein cholesterol (HDL-C; mean difference (MD) 2.28 mg/dL, 95% confidence interval (CI) 1.90 to 2.66) and triglyceride (TG; MD 3.22 mg/dL, 95% CI 1.13 to 5.31) compared with the pre-eradication levels. H. pylori eradication resulted in little to no difference in the low-density lipoprotein-cholesterol levels (MD −2.33 mg/dL, 95% CI −4.92 to 0.26). In the analyses of RCTs only, the findings for elevated HDL-C levels, but not TG, were robust. Conclusions: H. pylori eradication increases the HDL-C levels. Further studies are needed to elucidate the effects of lipid changes following H. pylori eradication on cardiovascular diseases.

scholarly journals The Current Strategy of Helicobacter pylori Eradication

2021 ◽  
Vol 96 (1) ◽  
pp. 13-21
Author(s):  
Yong Hwan Kwon
Keyword(s):  
Helicobacter Pylori ◽  
Clinical Practice ◽  
Antimicrobial Resistance ◽  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Eradication Rate ◽  
Meta Analysis ◽  
Cure Rate ◽  
Helicobacter Pylori Eradication ◽  
H Pylori

Helicobacter pylori (H. pylori) is the main cause of most gastroduodenal diseases. Triple therapy including two antibiotics, amoxicillin and clarithromycin, and a proton pump inhibitor given for a week has been recommended as the treatment of choice since the revision of the Korean H. pylori Clinical Practice Guidelines in 2013. However, antimicrobial resistance significantly decreased the cure rate of H. pylori eradication to 63.9%. Thus, the new H. pylori treatment regimen would be needed to increase the eradication rate in Korea. Recently, the update of clinical practice guideline for treatment of H. pylori was developed by conducting a meta-analysis. In this review, the recommended H. pylori eradication regimen in current 2020 guideline will be discussed.

scholarly journals Berberine Combined with Triple Therapy versus Triple Therapy for Helicobacter pylori Eradication: A Meta-Analysis of Randomized Controlled Trials

2018 ◽  
Vol 2018 ◽  
pp. 1-15 ◽  
Author(s):  
Xiaotao Jiang ◽  
Chenguang Jiang ◽  
Cihui Huang ◽  
Guoming Chen ◽  
Kailin Jiang ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Adverse Effects ◽  
Randomized Controlled Trials ◽  
Triple Therapy ◽  
Meta Analysis ◽  
Biomedical Literature ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
H Pylori

Objective. To assess the effects and safety of berberine combined with triple therapy on Helicobacter pylori (H. pylori) eradication in adults. Methods. PubMed, MEDLINE, EMBASE, Cochrane Library, and Chinese databases including China National Knowledge Infrastructure (CNKI), Wanfang data, Chinese Technology Journal Full-text Database (VIP), and China biomedical literature database (CBM) were searched to obtain the eligible studies published up to October 10, 2017. The primary outcome was eradication rate of H. pylori. The secondary outcome was incidence of adverse effects. Data analysis was conducted by RevMan5.2 and Stata V.9.0 software. Trial sequential analysis (TSA) was performed to assess the risk of random error and the validity of conclusion with TSA program version 0.9 beta. Results. The meta-analysis results indicated berberine combined with triple therapy could improve the eradication rates of H. pylori (urea breath test subgroup: RR=1.18, 95%CI=(1.12,1.24), P<0.00001, biopsy subgroup: RR=1.23, 95%CI=(1.13,1.34), P<0.00001) and reduce the total occurrence of adverse effects (OR=0.59, 95%CI(0.46, 0.75), P<0.0001) when compared with only using triple therapy. Besides, the incidence of nausea (OR=0.59, 95%CI(0.41, 0.86), P<0.05) and diarrhea (OR=0.41, 95%CI(0.24, 0.71) was remarkably lower in experimental group while that of abdominal distention (OR=0.64, 95%CI(0.40,1.04), P>0.05) and vomiting (OR=0.65, 95%CI(0.37, 1.15), P>0.05) had no significant change. TSA of H. pylori eradication rates and adverse effects incidence illustrated that the cumulative value of Z-curve went across the conventional boundary value, trial sequential monitoring boundary for benefit, and required information size, suggesting the results were stable. Conclusion. Evidence from meta-analysis suggested that berberine combined with triple therapy can be an option for increasing H. pylori eradication rates and reducing overall therapy-related adverse effects incidence, particularly nausea and diarrhea, whereas more randomized controlled trials designed according to CONSORT statement are demanded to support the efficacy in further studies.

scholarly journals Efficacy of dexlansoprazole-based triple therapy for Helicobacter pylori infections

2019 ◽  
Vol 12 ◽  
pp. 175628481987096
Author(s):  
Chia-Jung Kuo ◽  
Chun-Wei Chen ◽  
Puo-Hsien Le ◽  
Jun-Te Hsu ◽  
Cheng-Yu Lin ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Triple Therapy ◽  
Breath Test ◽  
Eradication Rate ◽  
Urea Breath Test ◽  
Helicobacter Pylori Eradication ◽  
Treatment Regimens ◽  
Group A ◽  
H Pylori ◽  
Group B

Background: Dexlansoprazole has been shown to be efficacious for the treatment of gastroesophageal reflux disease. However, there is a paucity of data about its efficacy for Helicobacter pylori eradication. The aim of this study was to evaluate the efficacy of dexlansoprazole for H. pylori eradication as triple therapy in real-world practice. Methods: Adult patients with endoscopically proven H. pylori related peptic ulcer diseases or gastritis were recruited for this study. The eradication status was assessed based on the results of the 13C-urea breath test performed 4 weeks after treatment. According to the different treatment regimens, the patients were allocated to group A: Esomeprazole 40 mg b.i.d. + amoxicillin 1 g b.i.d. + clarithromycin 500 mg b.i.d. for 7 days; group B: Esomeprazole 40 mg q.d. + amoxicillin 1 g b.i.d. + clarithromycin 500 mg b.i.d. for 7 days, or group C: Dexlansoprazole 60 mg q.d. + amoxicillin 1 g b.i.d. + clarithromycin 500 mg b.i.d. for 7 days. Results: A total of 215 patients (49% males) were enrolled in this study, with a mean age of 55 years. The eradication rates in group A, B, and C were 94.7% (71/75), 89.6% (69/77), and 93.7% (59/63) ( p = 0.457), respectively. The adverse events were similar between the three groups ( p = 0.068). Conclusions: This study suggests that dexlansoprazole-based triple therapy has an acceptable eradication rate for H. pylori infection.

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

2020 ◽  
Vol 13 ◽  
pp. 175628482093711
Author(s):  
Yang-Jie Zhu ◽  
Yi Zhang ◽  
Ting-Yi Wang ◽  
Jing-Tao Zhao ◽  
Zhe Zhao ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Adverse Events ◽  
Eradication Rate ◽  
Meta Analysis ◽  
Dual Therapy ◽  
Controlled Trials ◽  
High Dose ◽  
First Line ◽  
Quadruple Therapy ◽  
H Pylori

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

scholarly journals Efficiency of the Inclusion of Rebamipide in the Eradication Therapy for Helicobacter pylori Infection: Meta-Analysis of Randomized Controlled Studies

2019 ◽  
Vol 8 (9) ◽  
pp. 1498 ◽  
Author(s):  
Dmitrii N. Andreev ◽  
Igor V. Maev ◽  
Diana T. Dicheva
Keyword(s):  
Helicobacter Pylori ◽  
Randomized Controlled Trials ◽  
Citation Index ◽  
Meta Analysis ◽  
Eradication Therapy ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Therapy Regimen ◽  
Randomized Controlled ◽  
H Pylori

Background: There has been a negative trend in the effectiveness of classic eradication therapy regimens for Helicobacter pylori (H. pylori), which has largely been determined from the emergence and spread of antibiotic resistance. Several studies have shown that adding rebamipide to eradication regimens leads to an increase in the effectiveness of treatment. Aim: To evaluate the efficacy and safety of including rebamipide in the eradication regimens for H. pylori infection. Methods: The literature search was conducted in the MEDLINE/PubMed, EMBASE, Cochrane Central Register, Korean Medical Citation Index, and Russian Science Citation Index databases. All identified randomized controlled trials comparing rebamipide supplementation with non-rebamipide-containing eradication regimens for the treatment of H. pylori infection were included in the final analysis. Results: We identified 11 randomized controlled trials (RCTs) involving 1227 patients (631 in groups with rebamipide and 596 in groups without rebamipide). The meta-analysis showed that the addition of rebamipide to eradication regimens significantly increased the effectiveness of treatment (odds ratio (OR) 1.753, 95% confidence interval (CI) 1.312–2.333, p < 0.001). The subgroup analysis demonstrated that rebamipide significantly increased the effectiveness of eradication when added to a dual therapy regimen (OR 1.766, 95% CI: 1.167–2.495, p = 0.006); however, no significant improvement in effectiveness was observed when it was added to the triple therapy regimen (OR 1.638, 95% CI 0.833–3.219, p = 0.152). Conclusion: This meta-analysis demonstrated that the addition of rebamipide to H. pylori eradication regimens significantly increases the effectiveness of treatment.

The effect of CYP2C19 gene polymorphism on the eradication rate of Helicobacter pylori by proton pump inhibitors-containing regimens in Asian populations: a meta-analysis

2021 ◽  
Vol 22 (13) ◽  
pp. 859-879
Author(s):  
Juan Fu ◽  
Chang-Feng Sun ◽  
Hong-Yan He ◽  
Suvash Chandra Ojha ◽  
Han Shi ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Gene Polymorphism ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Eradication Rate ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Asian Populations ◽  
Cyp2c19 Polymorphism ◽  
H Pylori

Premise: The effects of proton pump inhibitors (PPI) depend on metabolic enzyme CYP2C19 that has different activity due to gene polymorphism. The purpose of this meta-analysis is to determine the potential effects of CYP2C19 polymorphism on the efficiency of PPI-based treatment. Materials & methods: The PubMed, EMBASE, Cochrane Library, etc. were searched for relevant articles published in English or Chinese from inception to 31 May 2020. Finally, 26 randomized controlled trials and 15 cohort studies met the inclusion criteria and used for the meta-analysis via STATA version 15. Results: Poor metabolizer (PM) genotype Helicobacter pylori eradication rates were highest for Asian individuals receiving triple or quadruple first-line therapy based on PPIs (p < 0.05). CYP2C19 polymorphism could influence H. pylori eradication rate only in Mainland China and Japan (p < 0.05). Conclusion: PM genotype facilitates the elimination of H. pylori in Asian populations. Rabeprazole-, esomeprazole- and pantoprazole-based eradication program was less affected by the CYP2C19 polymorphism.

scholarly journals Evidence-Based Guidelines for the Treatment of Helicobacter pylori Infection in Korea: 2020 Revised Edition

2021 ◽  
Vol 96 (3) ◽  
pp. 160-189
Author(s):  
Hye-Kyung Jung ◽  
Seung Joo Kang ◽  
Yong Chan Lee ◽  
Hyo-Joon Yang ◽  
Seon-Young Park ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Clinical Practice ◽  
Eradication Rate ◽  
Meta Analysis ◽  
Controlled Study ◽  
Evidence Based ◽  
School Students ◽  
Duodenal Ulcers ◽  
Intention To Treat ◽  
H Pylori

Helicobacter pylori (H. pylori) infection is one of the most common infectious diseases worldwide. Although its incidence is gradually decreasing, about half of the world's population still get infected. H. pylori infection is responsible for substantial gastrointestinal morbidity worldwide. It is the most common cause of gastric and duodenal ulcers as well as gastric cancer. Since the revision of the H. pylori Clinical Practice Guidelines in 2013, the eradication rate of H. pylori has gradually decreased with the use of classical triple therapy, wherein amoxicillin, clarithromycin, and proton pump inhibitors are administered, for 7 days. According to a nationwide randomized controlled study conducted by the Korean College of Helicobacter and Upper Gastrointestinal Research released in 2018, the intention-to-treat eradication rate was only 63.9%, which was due to increased antimicrobial resistance induced by the use of antibiotics, especially clarithromycin. The update of clinical practice guideline for treatment of H. pylori was developed based on evidence-based medicine by conducting a meta-analysis. The draft recommendations were finalized after expert consensus on three recommendations regarding the indication for treatment and eight recommendations on the treatment itself. These guidelines are designed to provide patients, nurses, medical school students, policymakers, and clinicians with clinical evidence to guide primary care and treatment of H. pylori infection. These may differ from current medical insurance standards and will be revised further, if necessary, based on research-based evidence.

scholarly journals Effect of Moxifloxacin-Triple Therapy Versus Clarithromycin-Triple Therapy for the Eradication of Helicobacter Pylori Infections Regarding to Age and BMI.

2019 ◽  
pp. 22-33
Keyword(s):  
Helicobacter Pylori ◽  
Triple Therapy ◽  
Eradication Rate ◽  
Age Groups ◽  
Normal Weight ◽  
Human Pathogens ◽  
Treatment Regimens ◽  
H Pylori ◽  
Triple Regimen ◽  
Group B

Helicobacter pylori (H. Pylori) is one of the most common infectious human pathogens, which infected more than (50%) of the populations worldwide. H. pylori induce inflammation, which causes of upper gastrointestinal illnesses including dyspepsia, peptic ulcer diseases, gastroesophageal reflux disease and gastric mucosa-associated lymphoid tissue (MALT) lymphoma. It is important to use a greatly effective and better tolerated eradication regimen. In this study, fifty newly diagnosed adult patients with H. pylori infection were included, they were allocated into two groups with two different treatment regimens for H. pylori eradications; Group A (25 patients) received oral conventional clarithromycin-triple therapy for 14 days. Group B (25 patients) received oral moxifloxacin triple therapy for 14 days. The results reported in this study indicated a significant higher eradication rate of triple moxifloxacin regimen (80%) of patients with H. pylori infections compared to that of triple clarithromycin regimen (52%). In the present study, using different H.pylori eradication regimens for patients with different age groups demonstrated no statistically significant differences in eradication rate achieved (p< 0.05). The result of this study showed that triple moxifloxacin therapy produced a significant higher eradication rate than clarithromycin triple therapy among normal weight patients with H. pylori infection (100% and 50% respectively (p=0.032)), while there was no significance difference among overweight and obese patients (p< 0.05) between the two groups. The present study concluded that the administration of moxifloxacin triple regimen for H. pylori eradication, demonstrated eradication effectiveness was significantly higher compared to that of clarithromycin triple regimen.

scholarly journals Drug-coated balloons for dysfunctional hemodialysis venous access: A patient-level meta-analysis of randomized controlled trials

2020 ◽  
Author(s):  
Fong Khi Yung ◽  
Joseph J Zhao ◽  
Eelin Tan ◽  
Nicholas Syn ◽  
Rehena Sultana ◽  
...  
Keyword(s):  
Random Effects ◽  
Meta Analysis ◽  
Venous Access ◽  
Primary Patency ◽  
Two Stage ◽  
Patient Level ◽  
Randomized Controlled ◽  
One Stage ◽  
Shared Frailty ◽  
Meta Analyses

ABSTRACTPurposeTo perform an individual patient data-level meta-analysis of randomized controlled trials comparing drug-coated balloon angioplasty (DCB) against conventional percutaneous transluminal angioplasty (PTA) in the treatment of dysfunctional hemodialysis venous access.MethodsA search was conducted from inception till 13th November 2020. Kaplan-Meier curves comparing DCB to PTA by target lesion primary patency (TLPP) and access circuit primary patency (ACPP) were graphically reconstructed to retrieve patient-level data. One-stage meta-analyses with Cox-models with random-effects gramma-frailties were conducted to determine hazard ratios (HRs). Dynamic restricted mean survival times (RMST) were conducted in view of violation of the proportional hazards assumption. Conventional two-stage meta-analyses and network meta-analyses under random-effects Frequentist models were conducted to determine overall and comparative outcomes of paclitaxel concentrations utilised. Where outliers were consistently detected through outlier and influence analyses, sensitivity analyses excluding those studies were conducted.ResultsAmong 10 RCTs (1,207 patients), HRs across all models favoured DCB (one-stage shared-frailty HR=0.62, 95%-CI: 0.53–0.73, P<0.001; two-stage random-effects HR=0.60, 95%-CI: 0.42–0.86, P=0.018, I2=65%) for TLPP. Evidence of time-varying effects (P=0.005) was found. TLPP RMST was +3.47 months (25.0%) longer in DCB-treated patients compared to PTA (P=0.001) at 3-years. TLPP at 6-months, 1-year and 2-years was 75.3% vs 58.0%, 51.1% vs 37.1% and 31.3% vs 26.0% for DCB and PTA respectively. P-Scores within the Frequentist network meta-analysis suggest that higher concentrations of paclitaxel were associated with better TLPP and ACPP. Among 6 RCTs (854 patients), the one-stage model favoured DCB (shared-frailty HR=0.72, 95%-CI: 0.60–0.87, P<0.001) for ACPP. Conversely, the two-stage random-effects model demonstrated no significant difference (HR=0.76, 95%-CI: 0.35–1.67, P=0.414, I2=81%). Sensitivity analysis excluding outliers significantly favoured DCB (HR=0.61, 95%-CI: 0.41–0.91, P=0.027, I2=62%).ConclusionOverall evidence suggests that DCB is favoured over PTA in TLPP and ACPP. The increased efficacy of higher concentrations of paclitaxel may warrant further investigation.

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