Helicobacter Pylori
Copyright ©2005 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 14, 2005; 11(18): 2726-2732
Published online May 14, 2005. doi: 10.3748/wjg.v11.i18.2726
Do patients with non-ulcer dyspepsia respond differently to Helicobacter pylori eradication treatments from those with peptic ulcer disease? A systematic review
Jia-Qing Huang, Ge-Fan Zheng, Richard H Hunt, Wai-Man Wong, Shiu-Kum Lam, Johan Karlberg, Benjamin Chun-Yu Wong
Jia-Qing Huang, Ge-Fan Zheng, Wai-Man Wong, Shiu-Kum Lam, Benjamin Chun-Yu Wong, Department of Medicine, Faculty of Medicine, University of Hong Kong, Hong Kong, China
Jia-Qing Huang, Johan Karlberg, Clinical Trials Center, Faculty of Medicine, University of Hong Kong, Hong Kong, China
Richard H Hunt, Department of Gastroenterology, McMaster University Medical Centre, Hamilton, Ontario, Canada
Author contributions: All authors contributed equally to the work.
Correspondence to: Benjamin Chun-Yu Wong, MD, Associate Professor, Department of Medicine, Faculty of Medicine, University of Hong Kong, Hong Kong, China. bcywong@hku.hk
Telephone: +852-2855-4542 Fax: +852-2872-5828
Received: September 24, 2004
Revised: September 25, 2004
Accepted: November 19, 2004
Published online: May 14, 2005
Abstract

AIM: It is controversial whether patients with non-ulcer dyspepsia (NUD) respond differently to Helicobacter pylori (H pylori) eradication treatment than those with peptic ulcer disease (PUD). To review the evidence for any difference in H pylori eradication rates between PUD and NUD patients.

METHODS: A literature search for full articles and meeting abstracts to July 2004 was conducted. We included studies evaluating the efficacy of a proton pump inhibitor (P) or ranitidine bismuth citrate (RBC) plus two antibiotics of clarithromycin (C), amoxicillin (A), metronidazole (M), or P-based quadruple therapies for eradicating the infection.

RESULTS: Twenty-two studies met the criteria. No significant difference in eradication rates was found between PUD and NUD patients when treated with 7-d RBCCA, 10-d PCA or P-based quadruple therapies. When the 7-d PCA was used, the pooled H pylori eradication rate was 82.1% (431/525) and 72.6% (448/617) for PUD and NUD patients, respectively, yielding a RR of 1.15 (95%CI 1.01-1.29). However, the statistically significant difference was seen only in meeting abstracts, but not in full publications.

CONCLUSION: There is no convincing evidence to suggest that NUD patients respond to H pylori eradication treatments differently from those with PUD, although a trend exists with the 7-d PCA therapy.

Keywords: H pylori eradication; Non-ulcer dyspepsia; Peptic ulcer disease; Meta-analysis