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Systematic review and meta‐analysis: Effect of Helicobacter pylori eradication on chronic spontaneous urticaria
Author(s) -
Kim Hyun Jung,
Kim Yeon-Ji,
Lee Ho Jung,
Hong Jeong Yeon,
Park A Young,
Chung Euy Hyun,
Lee Sung Yul,
Lee Jong Suk,
Park Young Lip,
Lee Sang Hoon,
Kim Jung Eun
Publication year - 2019
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.12661
Subject(s) - confidence interval , medicine , meta analysis , helicobacter pylori , relative risk , gastroenterology , spontaneous remission , pathology , alternative medicine
Background Helicobacter pylori (HP) infection is considered to play a role in the pathogenesis of chronic spontaneous urticaria (CSU). However, the efficacy of HP eradication therapy on CSU symptom improvement has not been well established. This meta‐analysis was conducted to estimate the association between HP infection and CSU and to evaluate whether HP eradication therapy benefits patients with CSU. Material and Methods In October 2018, we searched databases for studies investigating the efficacy of HP eradication therapy for patients with CSU. Risk ratios (RRs) and 95% confidence intervals (CIs) were pooled using random effects models. Results The meta‐analysis included 22 studies with a total of 1385 patients with CSU. When comparing the spontaneous remission of urticarial symptom in patients with HP‐positive to HP‐negative patients, HP‐negative patients showed significantly higher spontaneous remission of urticarial symptoms. (risk ratio 0.39; 95% confidence interval: 0.19‐0.81). Among HP‐positive CSU patients, remission of CSU was more likely shown in HP eradication therapy group compared to untreated group, aside from achieving HP elimination (risk ratio 2.10; 95% confidence interval: 1.20‐3.68). However, there was no significant difference in the remission of CSU whether antibiotic therapy was successful in eradication of HP or not (risk ratio 1.00; 95% confidence interval: 0.65‐1.54). Conclusions The results of this meta‐analysis show that HP might be associated with the occurrence and persistence of CSU. The effectiveness of HP eradication therapy in suppressing CSU symptoms was significant. Interestingly, we found that resolution of CSU was not associated with successful eradication of HP infection. CSU Patients who were undergone antibiotic therapy for HP eradication showed significant higher CSU remission with or without HP eradication. Further studies are recommended to evaluate the mechanisms associated with relation of HP with CSU.