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Standard Bismuth Quadruple Therapy versus Concomitant Therapy for the First-Line Treatment of Helicobacter pylori Infection: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

(1) Background: Whether standard bismuth quadruple therapy (BQT) is superior to concomitant therapy for the first-line treatment of Helicobacter (H.) pylori infection is unclear. The aim of this systematic review and meta-analysis was to compare the efficacy of standard BQT versus concomitant therap...

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Autores principales: Zagari, Rocco Maurizio, Dajti, Elton, Cominardi, Anna, Frazzoni, Leonardo, Fuccio, Lorenzo, Eusebi, Leonardo Henry, Vestito, Amanda, Lisotti, Andrea, Galloro, Giuseppe, Romano, Marco, Bazzoli, Franco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10179629/
https://www.ncbi.nlm.nih.gov/pubmed/37176698
http://dx.doi.org/10.3390/jcm12093258
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author Zagari, Rocco Maurizio
Dajti, Elton
Cominardi, Anna
Frazzoni, Leonardo
Fuccio, Lorenzo
Eusebi, Leonardo Henry
Vestito, Amanda
Lisotti, Andrea
Galloro, Giuseppe
Romano, Marco
Bazzoli, Franco
author_facet Zagari, Rocco Maurizio
Dajti, Elton
Cominardi, Anna
Frazzoni, Leonardo
Fuccio, Lorenzo
Eusebi, Leonardo Henry
Vestito, Amanda
Lisotti, Andrea
Galloro, Giuseppe
Romano, Marco
Bazzoli, Franco
author_sort Zagari, Rocco Maurizio
collection PubMed
description (1) Background: Whether standard bismuth quadruple therapy (BQT) is superior to concomitant therapy for the first-line treatment of Helicobacter (H.) pylori infection is unclear. The aim of this systematic review and meta-analysis was to compare the efficacy of standard BQT versus concomitant therapy for H. pylori eradication in subjects naïve to treatment. (2) Methods: Online databases were searched for randomized controlled trials. We pooled risk ratio (RR) of individual studies for dichotomous outcomes using a random-effect model. (3) Results: Six studies with 1810 adults were included. Overall intention-to-treat (ITT) eradication rate was 87.4% with BQT and 85.2% with concomitant therapy (RR 1.01, 95%CI:0.94–1.07). Subgroup analysis of five Asian studies showed a small but significant superiority of BQT over concomitant therapy (87.5% vs. 84.5%; RR 1.04, 95%CI:1.01–1.08). Pooling four studies at low risk of bias yielded a similar result (88.2% vs. 84.5%; RR 1.05, 95%CI:1.01–1.09). There was no difference between the regimens in the frequency of adverse events (RR = 0.97, 95%CI:0.79–1.2). (4) Conclusions: The efficacy of BQT seems to be similar to concomitant therapy, with similar side effect profile. However, BQT showed a small but significant benefit over concomitant therapy in Asian populations and in studies at low risk of bias.
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spelling pubmed-101796292023-05-13 Standard Bismuth Quadruple Therapy versus Concomitant Therapy for the First-Line Treatment of Helicobacter pylori Infection: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Zagari, Rocco Maurizio Dajti, Elton Cominardi, Anna Frazzoni, Leonardo Fuccio, Lorenzo Eusebi, Leonardo Henry Vestito, Amanda Lisotti, Andrea Galloro, Giuseppe Romano, Marco Bazzoli, Franco J Clin Med Systematic Review (1) Background: Whether standard bismuth quadruple therapy (BQT) is superior to concomitant therapy for the first-line treatment of Helicobacter (H.) pylori infection is unclear. The aim of this systematic review and meta-analysis was to compare the efficacy of standard BQT versus concomitant therapy for H. pylori eradication in subjects naïve to treatment. (2) Methods: Online databases were searched for randomized controlled trials. We pooled risk ratio (RR) of individual studies for dichotomous outcomes using a random-effect model. (3) Results: Six studies with 1810 adults were included. Overall intention-to-treat (ITT) eradication rate was 87.4% with BQT and 85.2% with concomitant therapy (RR 1.01, 95%CI:0.94–1.07). Subgroup analysis of five Asian studies showed a small but significant superiority of BQT over concomitant therapy (87.5% vs. 84.5%; RR 1.04, 95%CI:1.01–1.08). Pooling four studies at low risk of bias yielded a similar result (88.2% vs. 84.5%; RR 1.05, 95%CI:1.01–1.09). There was no difference between the regimens in the frequency of adverse events (RR = 0.97, 95%CI:0.79–1.2). (4) Conclusions: The efficacy of BQT seems to be similar to concomitant therapy, with similar side effect profile. However, BQT showed a small but significant benefit over concomitant therapy in Asian populations and in studies at low risk of bias. MDPI 2023-05-03 /pmc/articles/PMC10179629/ /pubmed/37176698 http://dx.doi.org/10.3390/jcm12093258 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Systematic Review
Zagari, Rocco Maurizio
Dajti, Elton
Cominardi, Anna
Frazzoni, Leonardo
Fuccio, Lorenzo
Eusebi, Leonardo Henry
Vestito, Amanda
Lisotti, Andrea
Galloro, Giuseppe
Romano, Marco
Bazzoli, Franco
Standard Bismuth Quadruple Therapy versus Concomitant Therapy for the First-Line Treatment of Helicobacter pylori Infection: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
title Standard Bismuth Quadruple Therapy versus Concomitant Therapy for the First-Line Treatment of Helicobacter pylori Infection: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
title_full Standard Bismuth Quadruple Therapy versus Concomitant Therapy for the First-Line Treatment of Helicobacter pylori Infection: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
title_fullStr Standard Bismuth Quadruple Therapy versus Concomitant Therapy for the First-Line Treatment of Helicobacter pylori Infection: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
title_full_unstemmed Standard Bismuth Quadruple Therapy versus Concomitant Therapy for the First-Line Treatment of Helicobacter pylori Infection: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
title_short Standard Bismuth Quadruple Therapy versus Concomitant Therapy for the First-Line Treatment of Helicobacter pylori Infection: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
title_sort standard bismuth quadruple therapy versus concomitant therapy for the first-line treatment of helicobacter pylori infection: a systematic review and meta-analysis of randomized controlled trials
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10179629/
https://www.ncbi.nlm.nih.gov/pubmed/37176698
http://dx.doi.org/10.3390/jcm12093258
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