Meta-analysis: comparative efficacy of different proton-pump inhibitors in triple therapy for Helicobacter pylori eradication.
BACKGROUND
It is not known whether certain proton-pump inhibitors are more efficacious than others when used in triple therapy for Helicobacter pylori eradication.


OBJECTIVE
To compare the efficacy of different proton-pump inhibitors in triple therapy by performing a meta-analysis.


METHODS
A MEDLINE search was performed. Abstracts of the European Helicobacter pylori Study Group and the American Gastroenterological Association congresses from 1996 to 2002 were also examined. Randomized studies with at least two branches of triple therapy that differed only in terms of type of proton-pump inhibitor were included in a meta-analysis using Review Manager 4.1.


RESULTS
Fourteen studies were included. Intention-to-treat cure rates were similar for omeprazole and lansoprazole: 74.7% vs. 76%, odds ratio (OR) 0.91 [95% confidence interval (CI) 0.69-1.21] in a total of 1085 patients; for omeprazole and rabeprazole: 77.9% vs. 81.2%, OR 0.81 (95% CI 0.58-1.15) in a total of 825 patients; for omeprazole and esomeprazole: 87.7% vs. 89%, OR 0.89 (95% CI 0.58-1.35) in 833 patients; and for lansoprazole and rabeprazole: 81% vs. 85.7%, OR 0.77 (95% CI 0.48-1.22) in 550 patients.


CONCLUSIONS
The efficacy of various proton-pump inhibitors seems to be similar when used for H. pylori eradication in standard triple therapy.
Vergara
M
M
Unitat de Malalties Digestives, Hospital de Sabadell, Institut Universitari Parc Taulí, UAB, Sabadell, Barcelona, Spain.
Vallve
M
M
Gisbert
J P
JP
Calvet
X
X
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D064098:Esomeprazole; D005069:Evaluation Studies as Topic; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D064747:Lansoprazole; D009853:Omeprazole / Q000031:analogs & derivatives / Q000627:therapeutic use; D054328:Proton Pump Inhibitors; D064750:Rabeprazole; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D001562:Benzimidazoles; D054328:Proton Pump Inhibitors; D064747:Lansoprazole; D064750:Rabeprazole; D009853:Omeprazole; D064098:Esomeprazole