Rescue Therapy with a Proton Pump Inhibitor Plus Amoxicillin and Rifabutin for Helicobacter pylori Infection: A Systematic Review and Meta-Analysis

Abstract EN

Background.

To conduct a systematic review and meta-analysis of clinical trials for eradication of Helicobacter pylori (H.

pylori) that included a treatment arm with a proton pump inhibitor, rifabutin, and amoxicillin.

Materials and Methods.

We selected clinical trials that examined the efficacy of H.

pylori eradication therapies and included a study arm using the test regimen from major medical literature databases and abstracts from major gastroenterology meetings.

We also did subgroup and sensitivity analyses.

Results.

Twenty-one studies were included in systematic review.

The total eradication rates of the test regimen were 70.4% by intent-to-treat (ITT) and 72.0% by per-protocol (PP) analyses.

The pooled odds ratio (OR) was 0.55 using fixed effects model (P=0.283) for the test regimen versus other triple regimens.

The total eradication rates were 68.4% for the test regimen and 81.9% in the control group by ITT, while the OR was 1.08 using random effects model (P=0.019).

The pooled eradication rate was 66.4% for the test regimen and 67.4% for the control group by ITT.

The total adverse effects incidence were 25.1% for the test regimen.

Conclusions.

The test regimen for H.

pylori rescue therapy may be not superior to control regimens in efficacy.