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Efficacy of Helicobacter pylori eradication therapies in Korea: A systematic review and network meta-analysis

Title
Efficacy of Helicobacter pylori eradication therapies in Korea: A systematic review and network meta-analysis
Author
이항락
Keywords
antibiotics; eradication therapy; Helicobacter pylori; network meta-analysis; tolerability
Issue Date
2017-08
Publisher
WILEY
Citation
HELICOBACTER, v. 22, no. 4, Article no. e12389
Abstract
Background: The efficacy of Helicobacter pylori eradication regimens may depend on the country where the studies were performed because of the difference in antibiotic resistance. We aimed to analyze the efficacy of H. pylori eradication regimens in Korea where clarithromycin resistance rate is high.Methods: We searched for all relevant randomized controlled trials published until November 2016 that investigated the efficacy of H. pylori eradication therapies in Korea. A network meta-analysis was performed to calculate the direct and indirect estimates of efficacy among the eradication regimens.Results: Forty-three studies were identified through a systematic review, of which 34 studies, published since 2005, were included in the meta-analysis. Among 21 included regimens, quinolone-containing sequential therapy for 14 days (ST-Q-14) showed the highest eradication rate (91.4% [95% confidence interval [CI], 86.9%-94.4%] in the intention-to-treat [ITT] analysis). The eradication rate of the conventional triple therapy for 7 days, standard sequential therapy for 10 days, hybrid therapy for 10-14 days, and concomitant therapy for 10-14 days was 71.1% (95% CI, 68.3%-73.7%), 76.2% (95% CI, 72.8%-79.3%), 79.4% (95% CI, 75.5%-82.8%), and 78.3% (95% CI, 75.3%-80.9%), respectively, in the ITT analysis. In the network meta-analysis, ST-Q-14 showed a better comparative efficacy than the conventional triple therapy, standard sequential therapy, hybrid therapy, and concomitant therapy. In addition, tolerability of ST-Q-14 was comparable to those regimens.Conclusion: In Korea, ST-Q-14 showed the highest efficacy in terms of eradication and a comparable tolerability, compared to the results reported for the conventional triple therapy, standard sequential therapy, hybrid therapy, and concomitant therapy.
URI
https://onlinelibrary.wiley.com/doi/abs/10.1111/hel.12389http://repository.hanyang.ac.kr/handle/20.500.11754/115294
ISSN
1083-4389; 1523-5378
DOI
10.1111/hel.12389
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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