Peptic Ulcer Research - Helicobacter pylori, Diet, Symptoms, Treatment

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Systematic review and meta-analysis: is 1-week proton pump inhibitor-based triple therapy sufficient to heal peptic ulcer?

Gisbert JP, Pajares JM

Department of Gastroenterology, University Hospital of La Princesa, Madrid, Spain. gisbert@meditex.es

AIMS: To systematically review the efficacy on ulcer healing of 1-week combination of a proton pump inhibitor plus two antibiotics and to perform a meta-analysis of randomized clinical trials to evaluate whether 7 days of proton pump inhibitor-based triple therapy is sufficient to heal peptic ulcer. METHODS: Studies where 1-week proton pump inhibitor-based triple therapy was administered to heal peptic ulcer were included. Randomized clinical trials comparing the efficacy on ulcer healing of 7-day proton pump inhibitor-based triple therapy versus this same regimen but prolonging the proton pump inhibitor for several more weeks were included in the meta-analysis. Electronic and manual bibliographical searches were conducted. Meta-analysis was performed combining the odds ratios of the individual studies. RESULTS: Twenty-four studies (2342 patients) assessed ulcer healing with 1-week proton pump inhibitor-based triple therapy. Mean healing rate was 86%, and 95% in Helicobacter pylori-eradicated patients. Six studies (862 patients), were included in the meta-analysis. Mean ulcer healing rate with a 7-day treatment was 91% versus 92% when proton pump inhibitor was prolonged for 2-4 more weeks (odds ratio = 1.11; 95% confidence interval = 0.71-1.74). CONCLUSION: In patients with peptic ulcer and H. pylori infection, prolonging therapy with proton pump inhibitor after a triple therapy for 7 days with a proton pump inhibitor and two antibiotics is not necessary to induce ulcer healing.

Published 1 April 2005 in Aliment Pharmacol Ther, 21(7): 795-804.
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Peptic Ulcer Books

MemoCharts Pharmacology: Drug therapy for peptic ulcers (Review chart) (Paperback)

MemoCharts Pharmacology: Drug therapy for peptic ulcers (Review chart) (Paperback)