A meta-analysis: comparison of esomeprazole and other proton pump inhibitors in eradicating Helicobacter pylori

BACKGROUND

To assess effects of esomeprazole-based therapies and others (PPIs) on Helicobacter pylori eradication when co-administered with antibiotics.

GOALS

Using the terms 'H. pylori eradication' and 'esomeprazole', we searched Medline, Embase, and the Cochrane Library (2000-2005) and conducted a manual search of related Chinese journals to identify randomized controlled trials (RCTs) that compared the treatment effects of esomeprazole and other PPI therapies in patients with H. pylori infection.

RESULTS

Of the 75 articles screened, 11 RCTs including 2,159 subjects were included in the meta-analysis. The mean H. pylori eradication rates (intention-to-treat, ITT) with esomeprazole + antibiotics was 86%, a rate comparable with other PPI therapies, 81% (ITT); the odds ratio (OR) was 1.38 (95% CI = 1.09-1.75). A focused meta-analysis of 6 selected high-quality studies was produced an OR of this comparison that was closer to one (1.17, 95% CI = 0.89-1.54), with the results being statistically homogeneous. Sub-analysis that included only studies comparing different does of esomeprazole with omeprazole or pantoprazole did not reveal significant differences. No additional serious adverse events were reported.

CONCLUSIONS

Esomeprazole-based triple therapy may effectively eradicate H. pylori infection and promote favorable outcome with good tolerance and offers comparable efficacy to omeprazole-based therapy.