First-line eradication of H pylori infection in Europe: A meta-analysis based on congress abstracts, 1997-2004

Table 1 Effect of PPI-based 1 wk triple therapies on the eradication of H pylori in European countries (pooled estimation of all treatment arms)

PPI+2AB	Cases (n)	Studies (n)	Treatment arms (n)	PER (%)	95% CI	P1	References
Omeprazole	7234	42	78	78.9	77.6-81.1		13-15, 17-19, 21-24, 26, 29, 37, 41, 43, 44, 49, 53, 57-63, 66-68, 73-76, 78-85
Lansoprazole	1048	12	17	82.9	79.2-81.1	0.95	12, 18, 22, 24, 25, 28, 32-38, 65
Pantoprazole	1216	9	13	80.1	76.5-83.6	0.84	27, 39-42, 63-65, 77
Rabeprazole	884	8	15	83.9	79.1-88.8	0.88	39, 49-56
Esomeprazole	752	6	14	81.1	80.3-88.0	0.80	43-48
All PPI	11134	77	136	81.4	78.5-84.5

¹ Omeprazole vs other PPIs; Test of homogeneity: Omeprazole, χ² = 6.12, P = 0.08; Lansoprazole, χ² = 5.56, P = 0.09; Pantoprazole, χ² = 1.46, P = 0.22; Rabeprazole, χ² = 3.45, P = 0.33; Esomeprazole, χ² = 1.96, P = 0.38.

Table 5 Results of the direct comparative trials of different antibiotic combinations on the eradication of H pylori in European countries

Antibioticcombination	Cases (n)	Studies (n)	Treatmentarms (n)	PER %	95% CI	P1	References	Antibioticcombination
PPI + C + A vs	2155	18	22	80.8	76.8-84.8	0.61	1.0 (0.90-1.20)	14,17,21,23,32-35,41,48,
PPI + C + N	2389	18	22	80.1	75.0-85.1			68, 69,71-74,78
PPI + C + A vs	1172	10	12	81.5	77.7-85.3	0.000 < 0.05	1.78 (1.46-2.16)	26,29,44,54-56,68,69,
PPI + A + N	1184	10	13	71.9	65.8-77.9			73,79
PPI + C + N vs	476	5	5	70.9	56.3-85.4	0.96	0.99 (0.77-1.29)	41,54,68,69,74
PPI + A + N	592	5	5	70.6	61.3-80.0
RBC + C + A vs	122	2	3	82.4	73.6-91.1	0.90	1.03 (0.61-1.75)	13,30
RBC + C + N	166	2	2	80.9	72.4-89.4

Test of homogeneity: PPI + C + A vs PPI + C + N, χ² = 0.01, P = 0.92; PPI + C + A vs PPI + A + N, χ² = 3.26, P = 0.07; PPI + C + N/PPI + A + N, χ² = 0.01, P = 0.99; RBC + C + A/RBC + C + N, χ² = 2.58, P = 0.11. PPI: proton pump inhibitors, A: amoxicillin; C: clarithromycin; N: nitroimidazoles; RBC: ranitidine bismuth citrate.

Table 2 Results of the direct comparative trials of the PPI-based 1-wk triple combinations

PPI comparation	Cases (n)	Studies (n)	Treatmentarms (n)	PER95% CI	P	OR (95% CI)	References
Omeprazole vs	601	5	9	87.3 (81.7-92.3)	0.22	0.83 (0.6-1.1)	32-37, 39
Lansoprazole	567	5	9	83.9 (75.0-92.3)
Omeprazole vs	83	1	1	89.0 (80.9-97.6)	0.24	0.61 (0.27-1.40)	39
Pantoprazole	85	1	1	79.6 (71.5-87.6)
Omeprazole vs	253	2	2	90.5 (84.6-96.4)	0.71	0.91 (0.53-1.55)	43, 44
Esomeprazole	256	2	2	91.5 (86.3-96.7)
Omeprazole vs	163	1	2	82.5 (74.2-90.8)	0.61	1.24 (1.00-1.48)	53
Rabeprazole	163	1	2	88.5 (81.3-95.7)

Test of homogeneity: Omeprazole/Lansoprazole, χ² = 2.76, P = 0.1; Omeprazole/Pantoprazole, χ² = 2.69, P = 0.12; Omeprazole/Rabeprazole, χ² = 2.45, P = 0.12; Omeprazole/Esomeprazole, χ² = 0.12, P = 0.72.

Table 3 Changes over time of the eradication rates of PPI-based one-triple therapies between 1997-2004

Yearreferences	Cases (n)	Studies (n)	Treatmentarms (n)	PER (%)	95% CI	P1	References
1997	3216	16	34	80.2	75.8-84.7		12,13,49,58,59,61-65,71-73,77,78,85
1998	1117	11	18	82.0	76.4-87.4	0.59	15,17,21-23,34-36,39
1999	1771	9	14	77.2	71.6-82.7	0.34	24-26,28,40,41,60,67,74
2000	1683	10	13	82.1	78.0-86.1	0.56	27,29,30,37,38,42,43,50,70
2001	1002	8	11	80.7	73.4-87.9	0.9	51-54,68,69,75,84
2002	904	4	7	87.1	80.8-93.4	0.12	41,55,57,76
2003	553	2	4	78.2	67.2-89.4	0.67	45,46
2004	468	3	5	82.6	73.5-91.6	0.65	47,48,56

¹P: 1997 vs other years; P = 0.04 < 0.05 2002 vs 1999; no other significant difference in between-year comparisons; Test of homogeneity: 1997, χ² = 9.98, P = 0.19; 1998, χ² = 0.71, P = 0.39; 1999, χ² = 3.0, P = 0.08; 2000, χ² = 5.17, P = 0.15; 2001, χ² = 0.15, P = 0.72; 2002, χ² = 0.2, P = 0.7; 2003, χ² = 0.14, P = 0.8; 2004, χ² = 0.14 , P = 0.8.

Table 4 The effect of antibiotic combinations on the eradication of H pylori in European countries (pooled estimation of all treatment arms)

Antibioticcombination	Cases (n)	Studies (n)	Treatmentarms (n)	PER %	95% CI	P	References
PPI + C + A	5610	40	49	81.3	77.8-84.8		12,14,22,24,26,31-34,36,39-42, 44-46,48,52,54-56,58,60-70,72-79,79
PPI + C + N	2080	25	27	83.8	81.7-85.9	0.961	14,23,25,27,28,32-34,39,43,44,47,48, 57,62,67-69,71-73,76,78
PPI + A + N	1577	15	19	73.5	66.6-78.5	0.012 < 0.05 0.0013 < 0.05	11,16,33,38,39,41,54-56,68,69,73, 78,79
RBC + C + A	589	8	9	82.6	76.2-89.0		12-14,17,22-26,30
RBC + C + N	1285	15	17	78.0	71.4-84.6	0.744	10,11,13-15,17-19,21,23-25,27,28,30
RBC + A + N	186	1	1	76.5	67.3-88.7	0.725	16,17

Test of homogeneity: PPI + C + A, χ² = 1.13, P = 0.28; PPI + C + N, χ² = 4.47, P = 0.03 < 0.05; PPI + A + N, χ² = 1.07, P = 0.29; RBC + C + A, χ² = 2.58, P = 0.11; RBC + C + N, χ² = 1.49, P = 0.47; RBC + A + N, χ² = 3.12, P = 0.1. C: clarithromycin; A: amoxicillin; N: nitroimidazole, PPI: proton pump inhibitors; RBC: ranitidin bismuth citrate. Notes:

¹ PPI + C + A vs PPI + C + N;

² PPI + C + A vs PPI + A + N;

³PPI + C + N vs PPI + A +N;

⁴ RBC + C + A vs RBC + C + N;

⁵ RBC + C + CA vs RBC + A + N.