| Has the impact of Helicobacter pylori therapy on ulcer recurrence in the United States been overstated? A meta-analysis of rigorously designed trials. | |
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MedLine Citation:
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PMID: 9732917 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The aim of this study was to assess the effect of H. pylori eradication on ulcer recurrence in North American duodenal ulcer patients by examining only treatment studies that met rigorous methodologic criteria. METHODS: Data sources were computerized bibliographic searches from 1983, review of reference lists, communication with companies that manufacture medications used for H. pylori therapy in the U.S., and H. pylori investigators, review of open presentations to the Food and Drug Administration, and review of abstracts from annual scientific meetings. Criteria for study inclusion were double blind, randomized North American trials of H. pylori therapy for duodenal ulcer, scheduled endoscopic follow-up exams for > or = 6 months, and H. pylori cure documented > or = 4 wk after completion of therapy by at least two endoscopic biopsy tests. Seven relevant trials were identified. Data were abstracted independently and disagreement was resolved by consensus. We obtained missing data and identified erroneous assessments through contact with an author or sponsor of all studies. RESULTS: The common odds ratio for ulcer recurrence was 0.20 (95% CI, 0.13-0.31) and 2.8 patients would need to be successfully treated to prevent one ulcer recurrence at 6 months. The pooled ulcer recurrence rate at 6 months in patients with H. pylori eradication was 20%. CONCLUSION: Results of North American studies of highest methodological quality confirm that H. pylori eradication markedly decreases ulcer recurrence. Nevertheless, 20% of patients in these studies had ulcer recurrence within 6 months, despite successful cure of infection and no reported use of NSAIDs. Non-H. pylori, non-NSAID ulcers may be more common in the U.S. than previously believed. |
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Authors:
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L Laine; R J Hopkins; L S Girardi |
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Publication Detail:
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Type: Journal Article; Meta-Analysis |
Journal Detail:
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Title: The American journal of gastroenterology Volume: 93 ISSN: 0002-9270 ISO Abbreviation: Am. J. Gastroenterol. Publication Date: 1998 Sep |
Date Detail:
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Created Date: 1998-09-15 Completed Date: 1998-09-15 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0421030 Medline TA: Am J Gastroenterol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1409-15 Citation Subset: IM |
Affiliation:
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Division of Gastrointestinal and Liver Diseases, U.S.C. School of Medicine, Los Angeles, California 90033, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Double-Blind Method Duodenal Ulcer / drug therapy*, microbiology Helicobacter Infections / drug therapy* Helicobacter pylori* Humans Odds Ratio Randomized Controlled Trials as Topic / standards Recurrence |
| Comments/Corrections | |
Comment In:
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Am J Gastroenterol. 1999 Oct;94(10):3083-4
[PMID:
10520889
]
ACP J Club. 1999 May-Jun;130(3):63 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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