There is much debate about the influence of pre-treatment with a proton pump inhibitor on Helicobacter pylori eradication.
The few studies investigating the influence of pre-treatment on triple and quadruple therapies did not find differences in eradication rates.
However, the high eradication rates make it difficult to study factors associated with therapy failure in small populations.
Dr Janssen and colleagues from The Netherlands performed a meta-analysis in order to overcome this problem.
The investigators searched the literature in order to identify randomized clinical trials comparing modern triple/quadruple therapies.
| Eradication rates were 81.3% for patients with pre-treatment |
81.2% for patients without pre-treatment
|Alimentary Pharmacology and Therapeutics|
The research team compared Helicobacter pylori eradication trials without pre-treatment with a proton pump inhibitor with trials of exactly the same regimen but with pre-treatment.
The researchers calculated the overall risk difference (with or without pre-treatment) by pooling the risk differences of the individual studies weighted by the inverse of their variances.
The research team identified 9 studies, investigating a total of 773 patients.
The researchers found that there was considerable variation regarding therapy regimen and duration.
The team noted that pooled eradication rates were 81.3% for patients with pre-treatment and 81.2% for patients without pre-treatment.
The (weighted) overall risk difference was 0.1%.
Dr Janssen concluded, "Pre-treatment with a proton pump inhibitor does not influence Helicobacter pylori eradication."