Gisbert J P, Khorrami S, Calvet X, Pajares J M
Servicio de Aparato Digestivo, Hospital Universitario de la Princesa, Madrid, Spain.
Aliment Pharmacol Ther. 2003 Mar 15;17(6):751-64. doi: 10.1046/j.1365-2036.2003.01450.x.
To perform a systematic review of the efficacy of rabeprazole-based therapies in Helicobacter pylori eradication, and to conduct a meta-analysis comparing the efficacy of rabeprazole and other proton pump inhibitors when co-prescribed with antibiotics.
Studies evaluating rabeprazole plus antibiotics were considered. Only randomized trials comparing rabeprazole and other proton pump inhibitors with antibiotics, and differing only in the proton pump inhibitor, were included in the meta-analysis. Electronic and manual bibliographic searches were conducted. The percentage (weighted mean) of successful eradication was calculated. Meta-analysis was performed by combining the odds ratios (OR) of the individual studies.
The eradication rates were as follows: 14-day rabeprazole-amoxicillin, 73%; rabeprazole-amoxicillin-clarithromycin for 3, 5, 7 and 10 days, 44%, 72%, 78% and 75%, respectively; low-dose rabeprazole (20 mg/day), amoxicillin and clarithromycin for 7 days, 81%; high-dose rabeprazole (40 mg/day), amoxicillin and clarithromycin for 7 days, 75%; 7-day rabeprazole-clarithromycin-nitroimidazole, 85%. Twelve comparative studies were included in the meta-analysis. The eradication rate with rabeprazole plus antibiotics was 79%; it was 77% with other proton pump inhibitors (OR = 1.15; 95% confidence interval, 0.93-1.42). Sub-analysis comparing rabeprazole at low doses (10 mg b.d.) with other proton pump inhibitors at standard doses (omeprazole 20 mg b.d. or lansoprazole 30 mg b.d.) showed no differences.
Rabeprazole achieves similar H. pylori eradication rates to omeprazole and lansoprazole when co-prescribed with antibiotics. Low doses of rabeprazole (10 mg b.d.), when administered with two antibiotics, may be sufficient to eradicate H. pylori infection.
对基于雷贝拉唑的疗法根除幽门螺杆菌的疗效进行系统评价，并进行荟萃分析，比较雷贝拉唑与其他质子泵抑制剂联合使用抗生素时的疗效。
纳入评估雷贝拉唑加抗生素的研究。荟萃分析仅纳入比较雷贝拉唑和其他质子泵抑制剂与抗生素联合使用、且仅质子泵抑制剂不同的随机试验。进行了电子和手工文献检索。计算成功根除的百分比（加权均值）。通过合并各研究的比值比（OR）进行荟萃分析。
根除率如下：14天的雷贝拉唑-阿莫西林疗法，73%；雷贝拉唑-阿莫西林-克拉霉素治疗3天、5天、7天和10天，分别为44%、72%、78%和75%；低剂量雷贝拉唑（20毫克/天）、阿莫西林和克拉霉素治疗7天，81%；高剂量雷贝拉唑（40毫克/天）、阿莫西林和克拉霉素治疗7天，75%；7天的雷贝拉唑-克拉霉素-硝基咪唑疗法，85%。荟萃分析纳入了12项比较研究。雷贝拉唑加抗生素的根除率为79%；其他质子泵抑制剂的根除率为77%（OR = 1.15；95%置信区间，0.93 - 1.42）。低剂量（每日两次，每次10毫克）雷贝拉唑与标准剂量（奥美拉唑每日两次，每次20毫克或兰索拉唑每日两次，每次30毫克）其他质子泵抑制剂的亚组分析显示无差异。
雷贝拉唑与抗生素联合使用时，根除幽门螺杆菌的率与奥美拉唑和兰索拉唑相似。低剂量雷贝拉唑（每日两次，每次10毫克）与两种抗生素联合使用时，可能足以根除幽门螺杆菌感染。
