Eradication of Helicobacter pylori infection in Europe: Meta-analysis of the results presented at the EHPSG/UEGW/meetings, 1997–2002

• Published in: Zeitschrift für Gastroenterologie
• Main Authors: Buzás, G, Józan, J
• Format: Conference Proceeding
• Language: German
• Published: 19.05.2004
• ISSN: 0044-2771; 1439-7803
• DOI: 10.1055/s-2004-827119

Background: Meta-analyses evaluated the results of H. pylori eradication based on randomized controlled trials. Aim: Meta-analysis of papers presented at EHPSG and UEGW from 1997 to 2002. Methods: Abstracts dealing with the eradication of H. pylori, have been reviewed and randomized, controlled studies from European countries were included. The studies were classified into groups based on similar eradication schedules and country of proveniance. The pooled eradication rates (PER) were calculated and analyzed by the MANOVA test. Results: 102 studies were accepted, comprising 25,644 cases/398 treatment arms/59 regimens. The PER of proton pump-inhibitor-based (PPI) first-line triple therapies was 80.4% (confidence interval: 78.9–81.8); ranitidine bismuth-citrate (RBC) based triple regimens were efficient in 79.9% (75.7–84.0) (p=0.95 vs. PPI). H2 blockers-based therapies achieved 68.6% (59.0–78.1) (p=0.0007 vs. PPI; p=0.005 vs. RBC-based regimens). Double combinations were efficient in 62.8% (p=0.0001 vs. triple regimens). Clarithromycin+amoxicillin/nitroimidazole combinations achieved 79.6% and 84.2%; amoxicillin+nitroimidazole regimen was efficient in 72.5%. Quadruple therapies were successful in 81.1% (76,6–85.6) of cases as first-line and 73.8% (61.2–86.4) as second-line regimens (p=0.77 and p=0.02 vs. triple regimens). The PERs varied from 58% to 92% in the European countries. Conclusions: The PERs of the primary PPI/RBC-based triple regimens was similar with the meta-analyses data. H2 blocker-based triple and double regimens were of lower efficacy. Quadruple regimens were not better than triple therapies. The eradication rates per country were variable.