A meta‐analysis comparing eradication, healing and relapse rates in patients with Helicobacter pylori‐associated gastric or duodenal ulcer

• Published in: Alimentary pharmacology & therapeutics 2001-12, Vol.15 (12), p.1949-1958
• Main Authors: Leodolter, A., Kulig, M., Brasch, H., Meyer‐Sabellek, W., Willich, S. N., Malfertheiner, P.
• Format: Article
• Language: English
• Subjects: Anti-Bacterial Agents - therapeutic use; Biological and medical sciences; Digestive system; Duodenal Ulcer - drug therapy; Duodenal Ulcer - microbiology; Duodenal Ulcer - prevention & control; Helicobacter Infections - drug therapy; Helicobacter Infections - microbiology; Helicobacter Infections - prevention & control; Helicobacter pylori - drug effects; Helicobacter pylori - isolation & purification; Humans; Medical sciences; Odds Ratio; Pharmacology. Drug treatments; Proton-Translocating ATPases - antagonists & inhibitors; Randomized Controlled Trials as Topic; Recurrence; Stomach Ulcer - drug therapy; Stomach Ulcer - microbiology; Stomach Ulcer - prevention & control
• ISSN: 0269-2813; 1365-2036
• DOI: 10.1046/j.1365-2036.2001.01109.x

Aim: To compare the effectiveness of Helicobacter pylori eradication in curing peptic ulcer disease in trials involving both gastric ulcer and duodenal ulcer. Methods: Twenty‐four relevant randomized controlled trials and randomized comparative trials met the predefined selection criteria. Only proton pump inhibitor‐based eradication trials were considered for the evaluation of eradication efficacy and ulcer healing. For the determination of relapse rates, all trials independent of the eradication therapy regimen were considered. Results: Data from 2102 patients were analysed comparing gastric ulcer with duodenal ulcer. No statistical differences between gastric ulcer and duodenal ulcer patients were found with regard to eradication rates (summarized odds ratio, 1.23; 95% confidence interval, 0.98–1.55) or ulcer relapse rates, whether in successfully H. pylori eradicated patients (summarized odds ratio, 0.69; 95% confidence interval, 0.26–1.84) or unsuccessfully H. pylori eradicated patients (summarized odds ratio, 1.48; 95% confidence interval, 0.85–2.56). Owing to heterogeneity, healing rates were not comparable. Conclusions: The eradication of H. pylori infection cures both gastric and duodenal ulcer, and the cure rates are similar. This suggests that H. pylori is the key factor in peptic ulcer disease independent of the ulcer site.