Editorial
Copyright ©2010 Baishideng.
World J Gastroenterol. Aug 21, 2010; 16(31): 3865-3870
Published online Aug 21, 2010. doi: 10.3748/wjg.v16.i31.3865
Table 1 Topics of meta-analyses of Helicobacter pylori eradication between 1992-2010
Topics of meta-analysisNo. of studies
First-line triple therapies25
PPI-based therapies22
Ranitidine bismuth citrate-based therapies3
Bismuth-based quadruple therapies2
Non-bismuth-based quadruple therapies1
Histamine H2 receptor blockers + two different antibiotics5
Rescue (second- and third-line) therapies3
Sequential therapies4
Alternative therapies4
Eradication in functional dyspepsia20
Eradication in peptic ulcer10
Effect of CagA status on eradication1
Gastric cancer prevention5
Eradication in children2
Eradication in prevention of NSAID-ulcers1
Eradication in extradigestive diseases5
Effect of probiotics on eradication results5
Eradication and antimicrobial resistance4
Effect of CYP polymorphism on eradication2
Adverse effects of eradication4
Multiple topics11
Total113
Table 2 First-line standard triple therapies for Helicobacter pylori eradication: chronological order and results of meta-analyses
AuthorDatabases, abstracts1Study periodNo. of studiesNo. of patientsEradication rate [ITT, (%) mean + 95% CI]Duration of treatment (d)Comments
Bazzoli et al[11]Medline1993-199614507LAC: 80.67L and O are equally efficient
OAC: 69.6
Laheij et al[12]Medline, abstracts1983-199864453 228PPI + A + C: 80.09 (NS)7-14
Huang et al[13]Medline, PubMed, abstracts1986-1998826123PPI + A + C: 89.5.6 (86.9-92.0)7C 500 mg b.i.d. achieved the best result
PPI + A + M: 90.8% (87.0-94.5)
Gisbert et al[14]PubMed1986-1999222862PPI + A + C: 81 (76-85)7PAC and PAN have similar efficiency
PPI + A + N: 84 (79-89)
Gisbert et al[15]PubMed + abstracts1995-1999121170RBC + A + C: 76.6 (72-81)7RBC + AC and PPI + AC have similar efficiency, RBC + CN has higher efficiency than PPI + CN
RBC + CN: 87.2 (83-91)
PPIAC: 73.7 (69-78)
PPIAN: 74.9 (71-84)
Calvet et al[16]Medline + abstracts1990-1999211349PPI + 2ABTriple therapies of 14 d are superior to 7, but not 10 d regimens
76 (68-86)7
82 (77-86)10
84 (79-8)14
Janssen et al[17]Medline + abstracts1994-2000473541RBC + A + C: 81 (71-96)5-10PPI + AC and NC are equally effective, RBCNC is superior to RBCAC
RBC + N + C: 88 (78-94)
PPI + A + C: 79 (24-95)
PPI + N + C: 79 (42-100)
Vallve et al[18]Medline + abstract1996-2000132391Single dose PPI: 77.7 (72-77)7Single dose PPI triple regimens are less efficient
Double dose PPI: 83.9 (81-85)
Vergara et al[19]Medline + abstracts1995-20021343293O: 74.7 (NS)7PPIs are similar in standard triple therapy
L: 74.7 (NS)
R: 77.9 (NS)
E: 87.9 (NS)
Gené et al[20]PubMed, abstracts1995-200251118Triple therapy: 79 (74-81)7-10The effectiveness of triple and quadruple therapies is similar
Quadruple therapy: 80 (77-84)
Gisbert et al[21]Medline, Embase, CINAHL, CCTR1996-200272226RAC: 79 (76-82)7-14R, O and L achieved similar results
OAC: 77 (74-80)
LAC: 77 (75-79)
Gisbert et al[22]Medline, congress abstracts1997-2003121137P + 2AB: 83 (78-88)7P, O and L achieved similar results
O, L + 2AB: 81 (77-86)
Gisbert et al[23]Medline, congress abstracts1999-20034816E + 2AB: 85 (81-89)7E + 2AB has comparable efficacy with O + 2AB
O + 2AB: 82 (78-86)
Gisbert et al[24]Medline, Embase, CINAHLISIWS + congress abstracts1997-2004144435RBC + C + A: 79.5 (72.2-83.7)7-10-14RBC or PPI + A + C are comparable, RBC + C + N is superior to PPI + C + N
PPI + C + A: 78.1 (73.6-84.1)7-10-14
RBC + C + N: 87.4 (82.8-93.6)7-10-14
PPI + C + N: 79.9 (73.6-84.8)7-10-14
Padol et al[25]Medline, Embase, CCTR1996-2005171569PPI + 2AB7-14O, but not L and R effect is influenced by CYP2C19 status
PM: 88.9 (81.2-97.6)
HomEM: 70.9 (64.3-77.4)
HetEM: 82.7 (75.3-89.2)
Suzuki et al[26]PubMed1998-2005141529CagA +: 84% (79-89%)7-14Presence of CagA is predictive for a successful eradication
CagA-: 73% (65-82)
Wang et al[27]Medline, Embase, CCTR2000-2005112159E + 2AB: 86%7E, O and P are of comparable efficiency
PPI + 2AB: 81%
Buzás et al[28]Abstracts1997-20047515 634PPI + 2AB: 81.4% (78.5-84.5)7PPIs, RBC + 2AB and quadruple regimens are equally efficient as first-line therapies
RBC + 2AB: 78.5% (70.5-84.3)
PPI + 2AB + bismuth: 82.6% (76.0-89.2)
Fuccio et al[29]Medline, Embase, CCTR, abstracts1996-2007214831PPI + 2AB:Extending triple therapy to 10-14 d is not useful
75% (72-77)7
80.7% (75.2-85.7)10
78.2% (74.3-82.6)14
Villoria et al[30]PubMed, ISIWS, Embase, CCTR CINAH, abstracts1990-200761703High-dose PPI: 82% (78-84)7High-dose PPIs are 8% more effective than standard doses in 7 d therapies
Standard dose PPI: 74% (NS)
Zhao et al[31]Medline, PubMed, Embase, ISIWB, CCTR, Chinese Databases1999-2007203330PMs: 91.6 (83-99)7-10-14O and L effects are dependent on CYP2C19 genotype, R effect is not dependent
HetEMs: 85.5 (79.6-92.3)
HomEMs: 74.6 (70.1-79.8)
Essa et al[32]PubMed, Embase, CCTR + abstracts1990-200891054Triple therapies: 76.8 (72.2-81.2)5-10Concomitant quadruple therapy is superior to standard triple therapy
Concomitant quadruple therapy: 89.7% (86.8-92.1)7
Luther et al[33]Medline, Embase, Google Scholar, CCTR, ACP Journal Club1996-200991679PPI + AC: 77.0 (71-84)7Triple and quadruple therapies yielded similar suboptimal results
PPI + 2AB +
Bi: 78.3 (71.7-84.6)