Tailored therapy for Helicobacter pylori eradication: A systematic review and meta-analysis
Background: Due to an increase in drug resistance, the eradication rate of H. pylori with empirical therapy has declined. Tailored therapy has been proposed as an alternative to standard empirical treatments. The necessity of personalized eradication therapy remains unclear. The aim of this study wa...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-09-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2022.908202/full |
| _version_ | 1798002061343719424 |
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| author | Qin Ma Hancong Li Jing Liao Jing Liao Zhaolun Cai Bo Zhang |
| author_facet | Qin Ma Hancong Li Jing Liao Jing Liao Zhaolun Cai Bo Zhang |
| author_sort | Qin Ma |
| collection | DOAJ |
| description | Background: Due to an increase in drug resistance, the eradication rate of H. pylori with empirical therapy has declined. Tailored therapy has been proposed as an alternative to standard empirical treatments. The necessity of personalized eradication therapy remains unclear. The aim of this study was to determine whether tailored therapy is superior to empirical therapy for H. pylori infection.Methods: We searched for eligible randomized controlled trials in the PubMed, Embase (Ovid), Wanfang, and Cochrane Central Register of Controlled Trials databases up to 10 December 2021. A random effects model comparing pooled relative risks (RRs) with 95% confidence intervals (CIs) was applied in the meta-analysis.Results: Twenty-one studies were included in the meta-analysis. In the first-line treatment, tailored therapy was more effective than empirical therapy (RR, 1.14 [95% CI, 1.08–1.21], I2 = 72.2%). In the second-line therapy setting, the results did not reveal significant differences between the two treatments (RR, 1.05 [95% CI, 0.84–1.30], I2 = 80.6%). A similar result was observed in mixed second- and third-line treatments (RR, 1.03 [95% CI, 0.96–1.11], I2 = 0.0%). Regarding adverse events, no significant differences were found between the two treatments (RR, 0.90 [95% CI, 0.80–1.01], I2 = 35.7%). Most of the results were highly heterogeneous.Conclusion: A tailored approach might provide a better eradication rate than empirical methods in first-line treatment. There might be no obvious advantage in second-line or mixed second- and third-line treatments third-line treatment. Due to the high heterogeneity, the results should be interpreted with caution. Further clinical studies are needed and justified. |
| first_indexed | 2024-04-11T11:46:11Z |
| format | Article |
| id | doaj.art-0ebfcf4e215d42deb12b97788f32ab8f |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-04-11T11:46:11Z |
| publishDate | 2022-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-0ebfcf4e215d42deb12b97788f32ab8f2022-12-22T04:25:32ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122022-09-011310.3389/fphar.2022.908202908202Tailored therapy for Helicobacter pylori eradication: A systematic review and meta-analysisQin Ma0Hancong Li1Jing Liao2Jing Liao3Zhaolun Cai4Bo Zhang5Division of Gastrointestinal Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, ChinaWest China School of Medicine, West China Hospital, Sichuan University, Chengdu, ChinaDivision of Gastrointestinal Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, ChinaWest China School of Nursing, Sichuan University, Chengdu, ChinaGastric Cancer Center, West China Hospital, Sichuan University, Chengdu, ChinaGastric Cancer Center, West China Hospital, Sichuan University, Chengdu, ChinaBackground: Due to an increase in drug resistance, the eradication rate of H. pylori with empirical therapy has declined. Tailored therapy has been proposed as an alternative to standard empirical treatments. The necessity of personalized eradication therapy remains unclear. The aim of this study was to determine whether tailored therapy is superior to empirical therapy for H. pylori infection.Methods: We searched for eligible randomized controlled trials in the PubMed, Embase (Ovid), Wanfang, and Cochrane Central Register of Controlled Trials databases up to 10 December 2021. A random effects model comparing pooled relative risks (RRs) with 95% confidence intervals (CIs) was applied in the meta-analysis.Results: Twenty-one studies were included in the meta-analysis. In the first-line treatment, tailored therapy was more effective than empirical therapy (RR, 1.14 [95% CI, 1.08–1.21], I2 = 72.2%). In the second-line therapy setting, the results did not reveal significant differences between the two treatments (RR, 1.05 [95% CI, 0.84–1.30], I2 = 80.6%). A similar result was observed in mixed second- and third-line treatments (RR, 1.03 [95% CI, 0.96–1.11], I2 = 0.0%). Regarding adverse events, no significant differences were found between the two treatments (RR, 0.90 [95% CI, 0.80–1.01], I2 = 35.7%). Most of the results were highly heterogeneous.Conclusion: A tailored approach might provide a better eradication rate than empirical methods in first-line treatment. There might be no obvious advantage in second-line or mixed second- and third-line treatments third-line treatment. Due to the high heterogeneity, the results should be interpreted with caution. Further clinical studies are needed and justified.https://www.frontiersin.org/articles/10.3389/fphar.2022.908202/fulleradicationHelicobacter pyloriH. pylorimicrobial sensitivity testspersonalized therapytailored therapy |
| spellingShingle | Qin Ma Hancong Li Jing Liao Jing Liao Zhaolun Cai Bo Zhang Tailored therapy for Helicobacter pylori eradication: A systematic review and meta-analysis Frontiers in Pharmacology eradication Helicobacter pylori H. pylori microbial sensitivity tests personalized therapy tailored therapy |
| title | Tailored therapy for Helicobacter pylori eradication: A systematic review and meta-analysis |
| title_full | Tailored therapy for Helicobacter pylori eradication: A systematic review and meta-analysis |
| title_fullStr | Tailored therapy for Helicobacter pylori eradication: A systematic review and meta-analysis |
| title_full_unstemmed | Tailored therapy for Helicobacter pylori eradication: A systematic review and meta-analysis |
| title_short | Tailored therapy for Helicobacter pylori eradication: A systematic review and meta-analysis |
| title_sort | tailored therapy for helicobacter pylori eradication a systematic review and meta analysis |
| topic | eradication Helicobacter pylori H. pylori microbial sensitivity tests personalized therapy tailored therapy |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2022.908202/full |
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