Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Incheon, Korea.
Gut Liver. 2013 Sep;7(5):546-51. doi: 10.5009/gnl.2013.7.5.546. Epub 2013 Aug 14.
BACKGROUND/AIMS: Sequential therapy (ST) for Helicobacter pylori infection in countries other than Korea has shown higher eradication rates than triple therapy (TT). The aim of this study was to evaluate the efficacy of ST in Korea by performing a meta-analysis.
We performed a comprehensive literature search on the efficacy of ST as a first-line therapy. The odds ratios (ORs) of eradicating H. pylori infection after ST compared with TT were pooled. Pooled estimates of the eradication rates of ST and TT were also calculated.
A total of six studies provided data on 1,759 adult patients. The ORs for the intention to treat (ITT) and the per-protocol (PP) eradication rate were 1.761 (95% confidence interval [CI], 1.403 to 2.209) and 1.966 (95% CI, 1.489 to 2.595). Pooled estimates of the ITT and PP eradication rate were 79.4% (95% CI, 76.3% to 82.2%) and 86.4% (95% CI, 83.5% to 88.8%), respectively, for the ST group, and 68.2% (95% CI, 62.1% to 73.8%) and 78.9% (95% CI, 68.9% to 81.7%), respectively, for the TT group.
Although ST presented a higher eradication rate than TT in Korea, the pooled eradication rates were lower than expected. Further studies are needed to validate ST as a first-line treatment for H. pylori in Korea.
背景/目的：在韩国以外的国家，序贯疗法（ST）治疗幽门螺杆菌感染的根除率高于三联疗法（TT）。本研究旨在通过荟萃分析评估 ST 在韩国的疗效。
我们对 ST 作为一线治疗的疗效进行了全面的文献检索。汇总了 ST 根除幽门螺杆菌感染的优势比（OR）与 TT 相比。还计算了 ST 和 TT 的根除率的汇总估计值。
共有 6 项研究提供了 1759 名成年患者的数据。意向治疗（ITT）和按方案（PP）的 OR 分别为 1.761（95%置信区间[CI]，1.403-2.209）和 1.966（95%CI，1.489-2.595）。ST 组的 ITT 和 PP 根除率的汇总估计值分别为 79.4%（95%CI，76.3%-82.2%）和 86.4%（95%CI，83.5%-88.8%），TT 组分别为 68.2%（95%CI，62.1%-73.8%）和 78.9%（95%CI，68.9%-81.7%）。
尽管 ST 在韩国的根除率高于 TT，但汇总的根除率低于预期。需要进一步的研究来验证 ST 作为韩国幽门螺杆菌的一线治疗方法。
