TITLE

Meta-analysis of the effect of H. pylori eradication therapy on the prevention of recurrent ulcer bleeding

AUTHOR(S)
Khorrami, S.; Gisbert, J.P.; Calvert, X.; Gabriel, R.; Carballo, F.; Pajares, J.M.
PUB. DATE
September 2002
SOURCE
Gut;Sep2002 Supplement 2, Vol. 51, pA61
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Purpose: To evaluate whether H. pylori eradication therapy is more effective than long-term maintenance antisecretory therapy in the prevention of recurrent haemorrhage from peptic ulcer. Methods: Data sources: PubMed database (searched items: pylori, bleeding, haemorrhage, haemorrhage) and abstracts from congresses until January 2001. Study selection: Trials which compared the effect of eradication therapy versus maintenance antisecretory treatment on the recurrence of ulcer bleeding were included. Studies with all patients taking NSAIDs or less than 6 months of follow-up were excluded. Data extraction: Meta-analysis combining the Odds Ratios (OR) of the individual studies in a global OR (Peto method) was performed, and number needed to treat (NNT) was calculated. Results: Ten studies fulfilled the inclusion criteria. Recurrent bleeding was reported in 2.2% (95%CI = 1.2-4%) of the patients who received eradication treatment and in 10.5% (7.5-13%) of those treated with antisecretory therapy (OR = 0.19; 0.11-0.34). NNT with eradication therapy (compared with antisecretory therapy) to prevent one rebleeding episode was 12. When patients taking NSAIDs were excluded, recurrent haemorrhage was observed in 2% (1-4.4%) of patients on eradication therapy and in 11% (7.2-14.8%) of those on long-term antisecretory treatment. Conclusions: H. pylori eradication therapy is more effective than maintenance antisecretory treatment to prevent recurrence of peptic ulcer bleeding and, therefore, it must be considered in all such patients.
ACCESSION #
9747646

 

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