A meta-analysis comparing eradication, healing and relapse rates in patients with Helicobacter pylori-associated gastric or duodenal ulcer.
OBJECTIVE
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.
Leodolter
A
A
Department of Gastroenterology, Hepatology and Infectious Diseases, University of Magdeburg, Magdeburg, Germany.
Kulig
M
M
Brasch
H
H
Meyer-Sabellek
W
W
Willich
S N
SN
Malfertheiner
P
P
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004381:Duodenal Ulcer / Q000188:drug therapy / Q000382:microbiology / Q000517:prevention & control*; D016481:Helicobacter Infections / Q000188:drug therapy / Q000382:microbiology / Q000517:prevention & control*; D016480:Helicobacter pylori / Q000187:drug effects / Q000302:isolation & purification; D006801:Humans; D016017:Odds Ratio; D006180:Proton-Translocating ATPases / Q000037:antagonists & inhibitors; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D013276:Stomach Ulcer / Q000188:drug therapy / Q000382:microbiology / Q000517:prevention & control*
D000900:Anti-Bacterial Agents; D006180:Proton-Translocating ATPases