Do patients with non-ulcer dyspepsia respond differently to Helicobacter pylori eradication treatments from those with peptic ulcer disease? A systematic review

doi:10.3748/wjg.v11.i18.2726

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Helicobacter Pylori

World J Gastroenterol. May 14, 2005; 11(18): 2726-2732
Published online May 14, 2005. doi: 10.3748/wjg.v11.i18.2726

Table 1 Characteristics of RBC-containing triple and quadruple therapies.

Refs	Combination regimens	Dose	Treatment duration	Eradication rate (ITT)		P
				PUD	NUD
				N/T.N (%)	N/T.N (%)
	Triple therapies
	RBCCA
6	RBC/Cla/Amo	400 mg b.i.d./500 mg b.i.d./1 g b.i.d.	7 d	20/23 (86.96)	18/22 (81.8)
15	RBC/Cla/Amo	400 mg b.i.d./500 mg b.i.d./1 g b.i.d.	7 d	13/18 (72.2)	48/57 (84.2)
16	RBC/Cla/Amo	400 mg b.i.d./500 mg b.i.d./1 g b.i.d.	7 d	19/23 (82.6)	66/76 (86.8)
	Others			52/64 (81.3)	132/155 (85.2)¹
13	RBC/Cla/Tin	400 mg b.i.d./500 mg b.i.d./500 mg b.i.d.	5 d	20/27 (74.1)	23/39 (58.97)	0.32
9	RBC/Cla/Tin	400 mg b.i.d./500 mg b.i.d./500 mg b.i.d.	5 d	6/9 (66.7)	9/12 (75)	0.95
16	RBC/Cla/Met	400 mg b.i.d./500 mg b.i.d./400 mg b.i.d.	7 d	20/21 (95.2)	69/78 (88.5)	0.61
16	RBC/Met/Tet	400 mg b.i.d./400 mg b.i.d./1 g b.i.d.	7 d	38/46 (82.6)	43/54 (79.6)	0.9
14	RBC/Fur/Tet	350 mg b.i.d./100 mg b.i.d./500 mg b.i.d.	7 d	20/24 (83.3)	31/36 (86.1)	0.94
14	RBC/Fur/Amo	350 mg b.i.d./100 mg b.i.d./1 g b.i.d.	7 d	15/19 (78.95)	34/41 (82.9)	0.99
	Quadruple therapy
6	RBC/Cla/Amo/Met	400 mg b.i.d./400 mg b.i.d./1 g b.i.d./500 mg b.i.d.	5 d	174/174 (100)	62/71 (87.3)	<0.05

RBC, ranitidine bismuth citrate; Cla, clarithromycin; Tin, tinidazole; Fur, furazolidone; Tet, tetracycline; Amo, amoxicillin; Met, metronidazole; b.i.d., twice daily; PUD, peptic ulcer disease; NUD, non-ulcer dyspepsia; N/T.N, number/total number.

¹Relative risk: 0.96 (95%CI 0.84-1.11).

Table 2 Characteristics of bismuth- or PPI-based quadruple therapies.

Refs	Combination regimens	Dose	Treatment duration	Eradication rate (ITT)		P
				PUD	NUD
				N/T.N (%)	N/T.N (%)
17	CBS/Met/Tet/Lan	120 mg ×8/250 mg ×8/250 mg ×8/30 mg b.i.d.	1d	22/33 (66.7)	5/13 (38.5)	0.16
17	CBS/Met/Tet/Lan	120 mg ×8/250 mg ×8/250 mg ×8/30 mg b.i.d.	2 d	26/35 (74.3)	20/40 (50)	0.06
13	Amo/Cla/Tin/Ome	1 g b.i.d./500 mg b.i.d./500 mg b.i.d./20 mg b.i.d.	5 d¹²	30/31 (96.8)	31/34 (91.2)	0.68
18	Bis/Met/Tet/Lan	120 mg q.i.d./400 mg t.i.d./500 mg q.i.d./30 mg q.d.	7 d	91/101 (90.1)	107/118 (90.7)	0.93
19	Bis/Met/Tet/Ome	120 mg q.i.d./400 mg t.i.d./500 mg q.i.d./30 mg q.d.	10 d	53/57 (93)	46/49 (93.9)	0.84
8	Bis/Met/Tet/Ome	120 mg q.i.d./500 mg t.i.d./500 mg q.i.d./20 mg b.i.d.	14 d	9/11 (81.8)	8/13 (61.5)	0.53

CBS, colloidal bismuth subcitrate; Met, metronidazole; Tet, tetracycline; Lan, lansoprazole; Bis, bismuth; Cla, clarithromycin; Rab, rabeprazole; Tin, tinidazole; Amo, amoxicillin; ×8, 8 times daily; q.i.d., four times daily; q.d., once daily; b.i.d., twice daily; Ome, omeprazole.

¹Rabeprazole and amoxicillin were used on d 1-5, clarithromycin and tinidazole on d 6-10;

²amoxicillin was used on d 1-5, clarithromycin and tinidazole on d 6-10, and omeprazole on d 1-10. PUD, peptic ulcer disease; NUD, non-ulcer dyspepsia; N/T.N, number/total number.

Table 3 Characteristics of triple therapies consisting of a PPI, clarithromycin and amoxicillin.

Refs	Combination regimens	Dose	Treatmentduration (d)	Eradication rate (ITT)		P
				PUD	NUD
				N/T.N (%)	N/T.N (%)
22	Ome/Cla/Amo	20 mg b.i.d./500 mg b.i.d./1 g b.i.d.	7	134/161 (83.2)	34/42 (81)
7	Ome/Cla/Amo	20 mg b.i.d.1/500 mg b.i.d./1 g b.i.d.	7	60/65 (92.3)	30/50 (60)
9	PPI/Cla/Amo	PPI b.i.d./500 mg b.i.d./1 g b.i.d .	7	27/34 (79.4)	15/21 (71.4)
11	Rab/Cla/Amo	20 mg b.i.d./500 mg b.i.d./1 g b.i.d.	7	101/135 (74.8)	288/392 (73.5)
20	Pan/Cla/Amo	40 mg b.i.d./500 mg b.i.d./1 g b.i.d.	7	27/29 (93.1)	13/19 (68.4)
27	Rab/Cla/Amo	20 mg b.i.d./500 mg b.i.d./1 g b.i.d.	7	82/101 (81.2)	68/93 (73)
				431/525 (82.1)	448/617 (72.6)²
10	Ome/Cla/Amo	40 mg b.i.d./800 mg b.i.d./2 g b.i.d.	7	87/98 (88.8)	6/6 (100)	0.388
10	Ome/Cla/Amo	40 mg b.i.d./1.6 g b.i.d./2 g b.i.d.	7	51/51 (100)	49/50 (98)	0.313
8	Lan/Cla/Amo	30 mg b.i.d./500 mg b.i.d./1 g b.i.d.	10	13/13 (100)	65/71 (91.6)
21	Ome/Cla/Amo	20 mg b.i.d./500 mg b.i.d./1 g b.i.d.	10	63/96 (65.6)	20/27 (74.1)
27	Rab/Cla/Amo	20 mg b.i.d./500 mg b.i.d./1 g b.i.d.	10	75/97 (77.3)	78/99 (78.8)
27	Ome/Cla/Amo	20 mg b.i.d./500 mg b.i.d./1 g b.i.d.	10	77/103 (74.8)	68/103 (73.1)
				231/309 (74.8)	231/300 (77)³

Ome, omeprazole; Lan, lansoprazole; Pan, pantoprazole; Rab, rabeprazole; Cla, clarithromycin; Amo, amoxicillin; daily; q.d., daily; b.i.d., twice daily. ¹Omeprazole was used for 2 wk. PUD, peptic ulcer disease; NUD, non-ulcer dyspepsia; PPI b.i.d., PPI in standard dose.

²RR (95%CI): 1.15 (1.01-1.29).

³RR (95%CI): 1.03 (0.95-1.12). N/T.N, number/total number.

Table 4 Characteristics of triple therapies consisting of a PPI, metronidazole and clarithromycin or amoxicillin.

Refs	Combination regimens	Dose	Treatment duration	Eradication rate (ITT)		P
				PUD	NUD
				N/T.N (%)	N/T.N (%)
23	Pan/Met/Cla	40 mg q.d./400 mg b.i.d./250 mg b.i.d.	7 d	54/65 (83.1)	21/24 (87.5)	0.613
23	Pan/Met/Cla	40 mg b.i.d./400 mg b.i.d./250 mg b.i.d.	7 d	54/64 (84.4)	18/22 (81.8)	0.781
24	Ome/Met/Cla	40 mg q.d./500 mg b.i.d./250 mg b.i.d.	7 d	15/19 (78.95)	5/6 (83.3)	0.819
25	Pan/Met/Amo	40 mg b.i.d./500 mg b.i.d./1 g b.i.d.	7 d	14/19 (73.7)	7/11 (63.6)	0.569
26	Ome/Met/Amo	40 mg q.d./400 mg t.i.d.1/750 mg b.i.d.	14 d	22/27 (81.5)	22/37 (59.5)	0.063

Ome, omeprazole; Pan, pantoprazole; Cla, clarithromycin; Amo, amoxicillin; Met, metronidazole; daily; q.d., daily; b.i.d., twice daily. 1Metronidazole was used for 5 d only. PUD, peptic ulcer disease; NUD, non-ulcer dyspepsia.

Citation: Huang JQ, Zheng GF, Hunt RH, Wong WM, Lam SK, Karlberg J, Wong BCY. Do patients with non-ulcer dyspepsia respond differently to Helicobacter pylori eradication treatments from those with peptic ulcer disease? A systematic review. World J Gastroenterol 2005; 11(18): 2726-2732
URL: https://www.wjgnet.com/1007-9327/full/v11/i18/2726.htm
DOI: https://dx.doi.org/10.3748/wjg.v11.i18.2726