PMID- 22803691
OWN - NLM
STAT- MEDLINE
DCOM- 20121218
LR  - 20220316
IS  - 1365-2036 (Electronic)
IS  - 0269-2813 (Linking)
VI  - 36
IP  - 5
DP  - 2012 Sep
TI  - Meta-analysis: esomeprazole or rabeprazole vs. first-generation pump inhibitors 
      in the treatment of Helicobacter pylori infection.
PG  - 414-25
LID - 10.1111/j.1365-2036.2012.05211.x [doi]
AB  - BACKGROUND: The decreasing efficacy of H. pylori eradication treatments over time 
      makes the search for better regimens and adjuvant medications a priority. AIM: To 
      conduct a meta-analysis of studies comparing rabeprazole or esomeprazole with 
      other proton pump inhibitors (PPI) or with each other in H. pylori eradication 
      treatment. SELECTION OF STUDIES: Randomised clinical trials comparing 
      esomeprazole or rabeprazole with first-generation PPIs 
      (omeprazole-lansoprazole-pantoprazole) or with each other. RESULTS: The 
      meta-analysis (35 studies, 5998 patients) showed higher eradication rates for 
      esomeprazole than for first-generation PPIs: 82.3% vs. 77.6%; 
      OR = 1.32(1.01-1.73); NNT = 21. Rabeprazole also showed better results than 
      first-generation PPIs: 80.5% vs. 76.2%; OR = 1.21(1.02-1.42); NNT = 23. PPI 
      dosage sub-analysis: only esomeprazole 40 mg b.d. improved results [83.5% 
      esomeprazole vs. 72.4% first generation; OR = 2.27(1.07-4.82); NNT = 9]. Whereas 
      rabeprazole 10 and 20 mg b.d. maintained results, esomeprazole 20 mg b.d. 
      obtained lower efficacy. Esomeprazole vs. rabeprazole sub-analysis (five 
      studies): no significant differences were found: 78.7% vs. 76.7%; 
      OR = 0.90(0.70-1.17). CYP2C19 sub-analysis: Genotype did not significantly affect 
      eradication either in first [OR = 1.76(0.99-3.12)] or new generation 
      [OR = 1.19(0.73-1.95)] PPIs. However, sub-analysis considering only extensive 
      metaboliser patients showed higher eradication with new-generation PPIs 
      [OR = 1.37(1.02-1.84)]. CONCLUSIONS: Esomeprazole and rabeprazole show better 
      overall H. pylori eradication rates than first-generation PPIs. This clinical 
      benefit is more pronounced in esomeprazole 40 mg b.d. regimens. In CYP2C19 
      extensive metabolisers, new-generation PPIs are more effective than 
      first-generation PPIs for H. pylori eradication. However, a general 
      recommendation of using new-generation PPIs in all scenarios remains unclear.
CI  - (c) 2012 Blackwell Publishing Ltd.
FAU - McNicholl, A G
AU  - McNicholl AG
AD  - Gastroenterology Unit, Hospital Universitario de la Princesa and Instituto de 
      Investigacion Sanitaria Princesa (IP), Madrid, Spain. adrian.mcn@gmail.com
FAU - Linares, P M
AU  - Linares PM
FAU - Nyssen, O P
AU  - Nyssen OP
FAU - Calvet, X
AU  - Calvet X
FAU - Gisbert, J P
AU  - Gisbert JP
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
DEP - 20120715
PL  - England
TA  - Aliment Pharmacol Ther
JT  - Alimentary pharmacology & therapeutics
JID - 8707234
RN  - 0 (2-Pyridinylmethylsulfinylbenzimidazoles)
RN  - 0 (Enzyme Inhibitors)
RN  - 0 (Proton Pump Inhibitors)
RN  - 32828355LL (Rabeprazole)
RN  - N3PA6559FT (Esomeprazole)
SB  - IM
MH  - 2-Pyridinylmethylsulfinylbenzimidazoles/*administration & dosage
MH  - Dose-Response Relationship, Drug
MH  - Enzyme Inhibitors/*administration & dosage
MH  - Esomeprazole/*administration & dosage
MH  - Helicobacter Infections/*drug therapy
MH  - Helicobacter pylori/drug effects
MH  - Humans
MH  - Proton Pump Inhibitors/*administration & dosage
MH  - Rabeprazole
MH  - Randomized Controlled Trials as Topic
MH  - Treatment Outcome
EDAT- 2012/07/19 06:00
MHDA- 2012/12/19 06:00
CRDT- 2012/07/19 06:00
PHST- 2012/03/20 00:00 [received]
PHST- 2012/04/05 00:00 [revised]
PHST- 2012/06/19 00:00 [revised]
PHST- 2012/06/20 00:00 [accepted]
PHST- 2012/07/19 06:00 [entrez]
PHST- 2012/07/19 06:00 [pubmed]
PHST- 2012/12/19 06:00 [medline]
AID - 10.1111/j.1365-2036.2012.05211.x [doi]
PST - ppublish
SO  - Aliment Pharmacol Ther. 2012 Sep;36(5):414-25. doi: 
      10.1111/j.1365-2036.2012.05211.x. Epub 2012 Jul 15.