文献类型：期刊文献

英文题名：Modified Dual Therapy as the Initial Management for Helicobacter pylori Eradication vs. Guideline-Suggested First-Line Management: a Meta-Analysis

作者：Shi, Lingfang[1];Yan, Chungen[1];Wang, Xiufang[1]

机构：[1]Shaoxing Univ, Affiliated Hosp, Dept Gastroenterol, Shaoxing 312000, Zhejiang, Peoples R China

年份：2022

卷号：41

期号：6

起止页码：1131

外文期刊名：LATIN AMERICAN JOURNAL OF PHARMACY

收录：SCI-EXPANDED(收录号：WOS:000810141200010)、、WOS

语种：英文

外文关键词：adverse effects; bismuth quadruple therapy; clarithromycin triple therapy; Helicobacter pylori eradication rate; Helicobacter pylori infection; modified dual therapy

外文摘要：We performed a meta-analysis to evaluate the effect of modified dual therapy as the initial management for Helicobacter pylori eradication compared with guideline-suggested first-line managements. A systematic literature search up to March 2022 was performed and 12 studies involved 3837 patients at the baseline of the studies; 1927 of them were treated with modified dual therapy, 305 used clarithromycin triple therapy, and 1605 used bismuth quadruple therapy as guideline-suggested first-line managements. Odds ratio (OR) with 95% confidence intervals (CIs) were calculated to assess the effect of modified dual therapy as the initial management for Helicobacter pylori eradication compared with guideline-suggested first-line management using the dichotomous method with a random or fixed-effect model. The use of modified dual therapy significantly lowered adverse effects outcomes in subjects with Helicobacter pylori infection compared with bismuth quadruple therapy (OR, 0.34; 95% CI, 0.28-0.42, p < 0.001); and compared with clarithromycin triple therapy (OR, 0.32; 95% CI, 0.19-0.55, p < 0.001). Also, modified dual therapy did not show any significant difference in intentiontotreat Helicobacter pylori eradication rate compared with bismuth quadruple therapy (OR, 1.22; 95% CI, 0.99-1.50, p = 0.06) and compared with clarithromycin triple therapy (OR, 1.26; 95% CI, 0.60-2.65, p = 0.54) in subjects with Helicobacter pylori infection. Similarly, modified dual therapy did not show any significant difference in per-protocol Helicobacter pylori eradication rate compared with bismuth quadruple therapy (OR, 1.22; 95% CI, 0.98-1.52, p = 0.07) and compared with clarithromycin triple therapy (OR, 1.11; 95% CI, 0.63-1.94, p = 0.72) in subjects with Helicobacter pylori infection. Using modified dual therapy significantly lowered adverse effects outcomes in all subjects with Helicobacter pylori infection compared with bismuth quadruple therapy; and clarithromycin triple therapy. Also, modified dual therapy did not show any significant difference in Helicobacter pylori eradication rate compared with bismuth quadruple therapy and clarithromycin triple therapy in subjects with Helicobacter pylori infection. The observed relationship implies that the use of modified dual therapy may be recommended as first-line management to treat Helicobacter pylori infection with lower adverse effects.