Abstract
Purpose: To assess the effect of eradication therapy for Helicobacter pylori on symptoms of nonulcer dyspepsia. Data Sources: Duplicate searches of bibliographic databases, reviews of proceedings of annual gastroenterology and H. pylori meetings from 1995 to 1999, reviews of reference lists, and contact with primary investigators and pharmaceutical manufacturers. Study Selection: Included studies 1) examined patients with nonulcer dyspepsia and H. pylori infection; 2) used combination therapy for H. pylori and a control therapy without efficacy against H. pylori; 3) were randomized, controlled trials; 4) lasted for at least 1 month after the end of therapy; and 5) assessed symptoms of nonulcer dyspepsia. Ten studies were included. Data Extraction: Independent, duplicate data extraction of the methodologic quality, population, intervention, study design, duration, and outcome of the trials. Data Synthesis: The odds ratio (OR) for treatment success in nonulcer dyspepsia with H. pylori eradication therapy compared with control therapy was 1.29 (95% CI, 0.89 to 1.89; P = 0.18). However, significant heterogeneity (P = 0.04) calls the validity of aggregating the data into question. Heterogeneity resolved with the exclusion of one study (OR, 1.07 [CI, 0.83 to 1.37]; P > 0.2). For predefined analysis of trials that used a specifically stated definition of dyspepsia (that is, upper abdominal pain or discomfort), the OR was 1.04 (CI, 0.80 to 1.35) without heterogeneity. For treatment that resulted in cure rather than persistent infection, the OR was 1.17 (CI, 0.87 to 1.59) without heterogeneity. Conclusion: This meta-analysis provides little support for the use of H. pylori eradication therapy in patients with nonulcer dyspepsia.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 361-369 |
| Number of pages | 9 |
| Journal | Annals of Internal Medicine |
| Volume | 134 |
| Issue number | 5 |
| State | Published - Mar 6 2001 |
| Externally published | Yes |
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ASJC Scopus subject areas
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Cite this
Therapy for Helicobacter pylori in patients with nonulcer dyspepsia : A meta-analysis of randomized, controlled trials. / Laine, L.; Schoenfeld, P.; Fennerty, M (Brian).
In: Annals of Internal Medicine, Vol. 134, No. 5, 06.03.2001, p. 361-369.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Therapy for Helicobacter pylori in patients with nonulcer dyspepsia
T2 - A meta-analysis of randomized, controlled trials
AU - Laine, L.
AU - Schoenfeld, P.
AU - Fennerty, M (Brian)
PY - 2001/3/6
Y1 - 2001/3/6
N2 - Purpose: To assess the effect of eradication therapy for Helicobacter pylori on symptoms of nonulcer dyspepsia. Data Sources: Duplicate searches of bibliographic databases, reviews of proceedings of annual gastroenterology and H. pylori meetings from 1995 to 1999, reviews of reference lists, and contact with primary investigators and pharmaceutical manufacturers. Study Selection: Included studies 1) examined patients with nonulcer dyspepsia and H. pylori infection; 2) used combination therapy for H. pylori and a control therapy without efficacy against H. pylori; 3) were randomized, controlled trials; 4) lasted for at least 1 month after the end of therapy; and 5) assessed symptoms of nonulcer dyspepsia. Ten studies were included. Data Extraction: Independent, duplicate data extraction of the methodologic quality, population, intervention, study design, duration, and outcome of the trials. Data Synthesis: The odds ratio (OR) for treatment success in nonulcer dyspepsia with H. pylori eradication therapy compared with control therapy was 1.29 (95% CI, 0.89 to 1.89; P = 0.18). However, significant heterogeneity (P = 0.04) calls the validity of aggregating the data into question. Heterogeneity resolved with the exclusion of one study (OR, 1.07 [CI, 0.83 to 1.37]; P > 0.2). For predefined analysis of trials that used a specifically stated definition of dyspepsia (that is, upper abdominal pain or discomfort), the OR was 1.04 (CI, 0.80 to 1.35) without heterogeneity. For treatment that resulted in cure rather than persistent infection, the OR was 1.17 (CI, 0.87 to 1.59) without heterogeneity. Conclusion: This meta-analysis provides little support for the use of H. pylori eradication therapy in patients with nonulcer dyspepsia.
AB - Purpose: To assess the effect of eradication therapy for Helicobacter pylori on symptoms of nonulcer dyspepsia. Data Sources: Duplicate searches of bibliographic databases, reviews of proceedings of annual gastroenterology and H. pylori meetings from 1995 to 1999, reviews of reference lists, and contact with primary investigators and pharmaceutical manufacturers. Study Selection: Included studies 1) examined patients with nonulcer dyspepsia and H. pylori infection; 2) used combination therapy for H. pylori and a control therapy without efficacy against H. pylori; 3) were randomized, controlled trials; 4) lasted for at least 1 month after the end of therapy; and 5) assessed symptoms of nonulcer dyspepsia. Ten studies were included. Data Extraction: Independent, duplicate data extraction of the methodologic quality, population, intervention, study design, duration, and outcome of the trials. Data Synthesis: The odds ratio (OR) for treatment success in nonulcer dyspepsia with H. pylori eradication therapy compared with control therapy was 1.29 (95% CI, 0.89 to 1.89; P = 0.18). However, significant heterogeneity (P = 0.04) calls the validity of aggregating the data into question. Heterogeneity resolved with the exclusion of one study (OR, 1.07 [CI, 0.83 to 1.37]; P > 0.2). For predefined analysis of trials that used a specifically stated definition of dyspepsia (that is, upper abdominal pain or discomfort), the OR was 1.04 (CI, 0.80 to 1.35) without heterogeneity. For treatment that resulted in cure rather than persistent infection, the OR was 1.17 (CI, 0.87 to 1.59) without heterogeneity. Conclusion: This meta-analysis provides little support for the use of H. pylori eradication therapy in patients with nonulcer dyspepsia.
UR - http://www.scopus.com/inward/record.url?scp=0035814971&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0035814971&partnerID=8YFLogxK
M3 - Article
C2 - 11242496
AN - SCOPUS:0035814971
VL - 134
SP - 361
EP - 369
JO - Annals of Internal Medicine
JF - Annals of Internal Medicine
SN - 0003-4819
IS - 5
ER -