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KMID : 0931320210210010048
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대한상부위장관.헬리코박터학회지
2021 Volume.21 No. 1 p.48 ~ p.58
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A 10- or 14-day Bismuth-containing Quadruple Therapy as a First-line Helicobacter pylori Eradication Therapy: A Systematic Review and Meta-analysis
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Kim Sung-Eun
Jung Hye-Kyung
Kang Seung-Joo
Lee Yong-Chan
Yang Hyo-Joon
Park Seon-Young
Shin Cheol-Min
Lim Hyun-Chul
Kim Jie-Hyun
Nam Su-Youn
Shin Woon-Geon
Park Jae-Myung
Choi Il-Ju
Kim Jae-Gyu
Choi Mi-Young
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Abstract
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Background/Aims: The eradication rate of the first-line standard triple therapy (STT) for Helicobacter pylori (H. pylori) infection has decreased since 2000; therefore, other first-line therapies are required. This study was aimed at investigating the efficacy of bismuth-containing quadruple therapy (PBMT) for first-line H. pylori eradication compared to STT, sequential therapy (SQT), and concomitant therapy (CT).
Materials and Methods: The Ovid-MEDLINE, Koreamed, EMBASE, KMBASE, and Cochrane Library databases were searched from January 2008 to July 2018. All identified randomized controlled trials (RCTs) comparing PBMT and non-PBMT for first-line H. pylori eradication therapy were included in the final analysis.
Results: A total of 3,653 patients from seven RCTs were enrolled. The pooled eradication rates of PBMT by intention-to-treat (ITT) and per-protocol (PP) analyses were 82.1% (95% CI, 68.2~90.8%) and 88.8% (95% CI, 77.1~94.9%), respectively. However, no statistically significant difference was observed in eradication rates of the 10- or 14-day PBMT as compared to 14-day STT, 10-day SQT, and 10-day CT in ITT and PP analyses. PBMT was significantly higher in adverse events than in the other eradication regimens (RR, 1.64; 95% CI, 1.11~2.44). Considerable heterogeneity in adverse events was observed among studies (χ2=88.7; P<0.001, I2=93%).
Conclusions: PBMT can be the first-line treatment for H. pylori eradication in Korea when other first-line options, including STT, SQT, or CT, are unavailable due to their high adverse event rates.
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KEYWORD
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Adverse effects, Bismuth tripotassium dicitrate, Disease eradication, Helicobacter pylori, Meta-analysis
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