| Proton pump inhibitor, clarithromycin and either amoxycillin or nitroimidazole: a meta-analysis of eradication of Helicobacter pylori. | |
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MedLine Citation:
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PMID: 11012477 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIM: To perform a meta-analysis of studies comparing twice daily, one-week triple therapy with a proton pump inhibitor, clarithromycin (C) and amoxycillin (A) (PCA) vs. those using proton pump inhibitor, clarithromycin and a nitroimidazole (N) (PCN) for H. pylori eradication. REVIEW METHODS: Selection criteria: Comparative randomized trials of PCA vs. PCN were included. Data sources: PubMed database and abstracts from congresses until September 1999. Statistics: Meta-analysis was performed combining the Odds Ratios (OR) of the individual studies in a global OR (Peto method) both on an intention-to-treat (ITT) and on a per protocol (PP) basis. RESULTS: Twenty-two studies fulfilled the inclusion criteria. Eighteen studies reported ITT and 20 PP analysis. Mean H. pylori eradication rates were 81% (95% CI: 79-83%) ITT, and 84% (82-86%) PP with PCA, and 81% (78-83%) ITT and 84% (82-86%) PP with PCN; the odds ratio for the effect of PCA vs. PCN was 1 (0.83-1.22) on an ITT, and 0.98 (0.8-1.2) on a PP basis. Subanalysis showed that mean H. pylori eradication efficacy with PC(250 b.d.)A was 81% (78-85%) ITT, vs. 86% (83-89%) with PC(250 b.d.)N. The odds ratio for this comparison was 0.68 (0.48-0.98). Finally, when comparing PC(500 b.d. )A against PC(250 b.d.)N ITT cure rates were 77% (74-80%), and 75% (72-78%) with an odds ratio of 1.18 (0.93-1.5). CONCLUSION: Overall, one-week combination regimens of PCA and PCN present similar H. pylori eradication efficacy. Nevertheless, the PCN regimen obtains significantly better results when using low doses of C (250 mg b.d.). |
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Authors:
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J P Gisbert; L González; X Calvet; N García; T López; M Roqué; R Gabriel; J M Pajares |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Meta-Analysis |
Journal Detail:
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Title: Alimentary pharmacology & therapeutics Volume: 14 ISSN: 0269-2813 ISO Abbreviation: Aliment. Pharmacol. Ther. Publication Date: 2000 Oct |
Date Detail:
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Created Date: 2000-11-16 Completed Date: 2000-11-16 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 8707234 Medline TA: Aliment Pharmacol Ther Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 1319-28 Citation Subset: IM |
Affiliation:
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Department of Gastroenterology, University Hospital of La Princesa, Madrid, Spain. gisbert@meditex.es |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Amoxicillin
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therapeutic use* Anti-Bacterial Agents / therapeutic use* Clarithromycin / therapeutic use* Enzyme Inhibitors / therapeutic use* Helicobacter Infections / drug therapy*, microbiology Helicobacter pylori* Humans Nitroimidazoles / therapeutic use* Penicillins / therapeutic use* Proton Pumps / antagonists & inhibitors* |
| Chemical | |
Reg. No./Substance:
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0/Anti-Bacterial Agents; 0/Enzyme Inhibitors; 0/Nitroimidazoles; 0/Penicillins; 0/Proton Pumps; 26787-78-0/Amoxicillin; 81103-11-9/Clarithromycin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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