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Review: Efficacy and Safety of Hybrid Therapy for Helicobacter pylori Infection: A Systematic Review and Meta‐analysis
Author(s) -
Wang Ben,
Wang YouHua,
Lv ZhiFa,
Xiong HuiFang,
Wang Hui,
Yang Yang,
Xie Yong
Publication year - 2015
Publication title -
helicobacter
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 79
eISSN - 1523-5378
pISSN - 1083-4389
DOI - 10.1111/hel.12180
Subject(s) - medicine , relative risk , meta analysis , randomized controlled trial , concomitant , adverse effect , combination therapy , confidence interval
Objectives To assess the efficacy and safety of hybrid therapy compared to other pre‐existing therapies and to new therapies. Methods Through a search of PubMed, EMBASE , the Cochrane Central Register of Controlled Trials, and Conference Proceedings Citation Index, two independent reviewers systemically identified randomized, controlled trials that compared hybrid therapy to other pre‐existing and new therapies. Dichotomous data were pooled to obtain the relative risk ( RR ) of the eradication rate, with 95% confidence intervals ( CI s). Results We identified 6 studies, 5 of which compared hybrid therapy and sequential therapy, and 3 of which compared hybrid therapy and concomitant therapy. Pooled estimates of the 5 randomized controlled trials ( RCT s) revealed no significant differences between hybrid therapy and sequential therapy and no evidence of heterogeneity ( I 2 = 0%; p = .803), the pooled RR s were 1.02 (95% CI : 0.93–1.12) (intention‐to‐treat ( ITT )), and 1.03 (95% CI : 0.94–1.13) (per protocol ( PP )). Pooled estimates of the 3 RCT s showed no significant differences between hybrid therapy and concomitant therapy with no evidence of heterogeneity ( I 2 = 0%; p = .967), the pooled RR s were 0.99 (95% CI : 0.89–1.10) ( ITT ) and 0.99 (95% CI : 0.89–1.10) ( PP ). No significant differences in adverse events were noted among hybrid therapy, sequential therapy, and concomitant therapy (( RR : 1.13; 95% CI : 0.87–1.48; I 2 = 13.2%; p = .327), ( RR : 0.89; 95% CI : 0.73–1.08; I 2 = 0%; p = .978) ( ITT ), respectively). After consideration of all treatment arms, the ITT eradication rates with hybrid therapy, concomitant therapy, and sequential therapy were 88.6, 86.3, and 84.7%, respectively. And the PP eradication rates were 92.1, 92.5, and 87.5%. No significant differences were observed between the groups in terms of compliance. Conclusions All three of these therapies yielded good eradication rates. Hybrid therapy could be an alternative to sequential therapy and concomitant therapy, but additional RCT s are needed to confirm this finding.