沃克酰胺-阿莫西林双重疗法与含铋四联疗法治疗幽门螺杆菌感染患者的疗效和安全性：一项荟萃分析。

Efficacy and safety of vonoprazan-amoxicillin dual therapy versus bismuth-containing quadruple therapy for patients with infection: a meta-analysis.

作者信息

Li Xiao, Jiang Cheng, Su Yuwen, Gao Ruiyun, Yang Peijun, Qin Yuechen, Zou Yue, Liang Weiming, Quan Jieru, Pan Liying

机构信息

The First Affiliated Hospital of Guangxi University of Science and Technology, Guangxi University of Science and Technology, Liuzhou, Guangxi, China.

Lingui Campus, Guilin Medical University, Guilin, Guangxi, China.

出版信息

Front Microbiol. 2025 Mar 19;16:1561749. doi: 10.3389/fmicb.2025.1561749. eCollection 2025.

INTRODUCTION

This meta-analysis aims to compare the efficacy and safety of vonoprazan-amoxicillin (VA) dual therapy in comparison to bismuth-containing quadruple therapy (BQT) for patients with () infection.

MATERIALS AND METHODS

Four databases (PubMed, Embase, Web of Science, and Cochrane Library) were searched published from establishment of database to June 1, 2024, for articles studying VA dual therapy compared to BQT for patients with infection. Meta-analyses of eradication rates, adverse events, compliance and cost were preformed.

RESULTS

A total of 17 studies were included for meta-analysis. Compared with BQT, VA increased the incidence of eradication rate, with significant difference under the ITT analysis (86.9% vs. 80.4%, RR = 1.07, 95% CI: 1.01-1.12,  = 0.01) but there no significant difference under the PP analysis (90.7% vs. 86.5%, RR = 1.03, 95% CI: 0.99-1.08,  = 0.13). Besides, VA significantly increased compliance (RR = 1.03, 95% CI: 1.01-1.05,  < 0.01) and decreased the occurrence of total adverse events (27.0% vs. 11.5%, RR = 0.43, 95% CI: 0.37-0.51,  < 0.01). Furthermore, VA has lower cost compared to BQT.

CONCLUSION

Our findings indicated that VA dual therapy provided a higher eradication rate, enhanced compliance, decreased adverse events, and lowered cost relative to BQT for patients with infection.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024576738, identifier CRD42024576738 (PROSPERO).

引言

本荟萃分析旨在比较沃克帕唑-阿莫西林（VA）双联疗法与含铋四联疗法（BQT）治疗（）感染患者的疗效和安全性。

材料与方法

检索了四个数据库（PubMed、Embase、Web of Science和Cochrane图书馆），从数据库建立至2024年6月1日发表的研究VA双联疗法与BQT治疗感染患者的文章。对根除率、不良事件、依从性和成本进行了荟萃分析。

结果

共纳入17项研究进行荟萃分析。与BQT相比，VA提高了根除率，在ITT分析下有显著差异（86.9%对80.4%，RR = 1.07，95%CI：1.01 - 1.12，P = 0.01），但在PP分析下无显著差异（90.7%对86.5%，RR = 1.03，95%CI：0.99 - 1.08，P = 0.13）。此外，VA显著提高了依从性（RR = 1.03，95%CI：1.01 - 1.05，P < 0.01），并减少了总不良事件的发生（27.0%对11.5%，RR = 0.43，95%CI：0.37 - 0.51，P < 0.01）。此外，与BQT相比，VA成本更低。