Premium
Meta‐analysis: proton pump inhibitors vs. H 2 ‐receptor antagonists — their efficacy with antibiotics in Helicobacter pylori eradication
Author(s) -
Gisbert J. P.,
Khorrami S.,
Calvet X.,
Gabriel R.,
Carballo F.,
Pajares J. M.
Publication year - 2003
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.2003.01766.x
Subject(s) - medicine , odds ratio , helicobacter pylori , antibiotics , confidence interval , meta analysis , gastroenterology , pharmacology , proton pump inhibitor , microbiology and biotechnology , biology
Summary Background : It is unknown whether proton pump inhibitors are superior to H 2 ‐receptor antagonists in Helicobacter pylori eradication regimens. Aim : To perform a meta‐analysis comparing the efficacy of both antisecretors when co‐prescribed with antibiotics. Methods : Randomized clinical trials comparing proton pump inhibitors vs. H 2 ‐receptor antagonists with the same antibiotics were selected. Data sources included PubMed, the Cochrane Controlled Trials Register and abstracts from congresses up to January 2002. A meta‐analysis was performed by combining the odds ratios. Results : Twenty studies fulfilled the inclusion criteria. In the intention‐to‐treat analysis, the mean eradication rates with proton pump inhibitors and H 2 ‐receptor antagonists plus antibiotics were 74% [95% confidence interval (CI), 71–76%] and 69% (95% CI, 66–71%), respectively. The odds ratio for this comparison was 1.31 (95% CI, 1.09–1.58). The number needed to treat with proton pump inhibitors to achieve eradication success, compared with H 2 ‐receptor antagonists, was 25. When studies prescribing very high doses of H 2 ‐receptor antagonists (two of the outliers) were excluded, the odds ratio (for proton pump inhibitors vs. H 2 ‐receptor antagonists) increased to 1.37, the number needed to treat decreased to 20 and the heterogeneity between the studies decreased. Conclusions : Overall, proton pump inhibitors are more effective than H 2 ‐receptor antagonists when prescribed at usual doses with antibiotics to eradicate H. pylori infection.