Eradication Rates of Clarithromycin Triple Therapy in Korea: A Systematic Review and Meta-analysis
Background/Aims Standard triple therapy, including a proton pump inhibitor, clarithromycin, and amoxicillin, has been recommended as the first-line for Helicobacter pylori infection. However, the eradication rate of standard triple therapy has declined over the past years because of the increasing r...
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| Format: | Article |
| Language: | English |
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Korean College of Helicobacter and Upper Gastrointestinal Research
2021-03-01
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| Series: | The Korean Journal of Helicobacter and Upper Gastrointestinal Research |
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| Online Access: | http://www.helicojournal.org/upload/pdf/kjhugr-2020-0056.pdf |
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| author | Seung Joo Kang Hye-Kyung Jung Yong Chan Lee Hyo-Joon Yang Seon-Young Park Cheol Min Shin Sung Eun Kim Hyun Chul Lim Jie-Hyun Kim Su Youn Nam Woon Geon Shin Jae Myung Park Il Ju Choi Jae Gyu Kim Miyoung Choi |
| author_facet | Seung Joo Kang Hye-Kyung Jung Yong Chan Lee Hyo-Joon Yang Seon-Young Park Cheol Min Shin Sung Eun Kim Hyun Chul Lim Jie-Hyun Kim Su Youn Nam Woon Geon Shin Jae Myung Park Il Ju Choi Jae Gyu Kim Miyoung Choi |
| author_sort | Seung Joo Kang |
| collection | DOAJ |
| description | Background/Aims Standard triple therapy, including a proton pump inhibitor, clarithromycin, and amoxicillin, has been recommended as the first-line for Helicobacter pylori infection. However, the eradication rate of standard triple therapy has declined over the past years because of the increasing resistance to clarithromycin in Korea. We analyzed the eradication rates and the 10-year change in the eradication rates in Korea. Methods PubMed, EMBASE, the Cochrane Library, and KoreaMed were searched for studies published between January 2007 and June 2018. The pooled eradication rates and their 95% CIs were estimated using a random-effect logistic regression model. Results Twenty-six randomized controlled studies on standard triple therapy conducted in Korea were selected. The intention-to-treat (ITT) and per protocol analyses showed pooled eradication rates of standard triple therapy of 71.6% (95% CI, 69.9~73.3%) and 79.6% (95% CI, 76.6~82.2%), respectively. The eradication rate decreased with time. The ITT analysis showed that the 14-day therapy (78.1% [95% CI, 75.2~80.7%]) had significantly higher eradication rates than the 7-day therapy (70.0% [95% CI, 68.5~71.4%]) (P<0.01). Conclusions These results suggest that the eradication rate of standard triple therapy, as the first-line therapy, has shown an unacceptable decrease. The eradication rate increased when the duration of therapy was increased to 14 days, but it was not satisfactory. Therefore, other treatment regimens or therapies based on susceptibility tests should be considered for the first-line therapy. |
| format | Article |
| id | doaj-art-a2db43827d99426d9adea26efedc786d |
| institution | Kabale University |
| issn | 1738-3331 |
| language | English |
| publishDate | 2021-03-01 |
| publisher | Korean College of Helicobacter and Upper Gastrointestinal Research |
| record_format | Article |
| series | The Korean Journal of Helicobacter and Upper Gastrointestinal Research |
| spelling | doaj-art-a2db43827d99426d9adea26efedc786d2025-08-20T03:56:59ZengKorean College of Helicobacter and Upper Gastrointestinal ResearchThe Korean Journal of Helicobacter and Upper Gastrointestinal Research1738-33312021-03-01211354710.7704/kjhugr.2020.0056663Eradication Rates of Clarithromycin Triple Therapy in Korea: A Systematic Review and Meta-analysisSeung Joo Kang0Hye-Kyung Jung1Yong Chan Lee2Hyo-Joon Yang3Seon-Young Park4Cheol Min Shin5Sung Eun Kim6Hyun Chul Lim7Jie-Hyun Kim8Su Youn Nam9Woon Geon Shin10Jae Myung Park11Il Ju Choi12Jae Gyu Kim13Miyoung Choi14Department of Internal Medicine, Seoul National University Hospital Gangnam Center, Seoul, KoreaDepartment of Internal Medicine, Ewha Womans University School of Medicine, Seoul, KoreaDepartment of Internal Medicine, Yonsei University College of Medicine, Seoul, KoreaDivision of Gastroenterology, Department of Internal Medicine and Gastrointestinal Cancer Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, KoreaDepartment of Internal Medicine, Chonnam National University Medical School, Gwangju, KoreaDepartment of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, KoreaDepartment of Internal Medicine, Kosin University College of Medicine, Busan, KoreaDepartment of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, KoreaDepartment of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, KoreaDepartment of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, KoreaDepartment of Internal Medicine, Hallym University College of Medicine, Seoul, KoreaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, KoreaCenter for Gastric Cancer, National Cancer Center, Goyang, KoreaDepartment of Internal Medicine, Chung-Ang University College of Medicine, Seoul, KoreaDivision of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, KoreaBackground/Aims Standard triple therapy, including a proton pump inhibitor, clarithromycin, and amoxicillin, has been recommended as the first-line for Helicobacter pylori infection. However, the eradication rate of standard triple therapy has declined over the past years because of the increasing resistance to clarithromycin in Korea. We analyzed the eradication rates and the 10-year change in the eradication rates in Korea. Methods PubMed, EMBASE, the Cochrane Library, and KoreaMed were searched for studies published between January 2007 and June 2018. The pooled eradication rates and their 95% CIs were estimated using a random-effect logistic regression model. Results Twenty-six randomized controlled studies on standard triple therapy conducted in Korea were selected. The intention-to-treat (ITT) and per protocol analyses showed pooled eradication rates of standard triple therapy of 71.6% (95% CI, 69.9~73.3%) and 79.6% (95% CI, 76.6~82.2%), respectively. The eradication rate decreased with time. The ITT analysis showed that the 14-day therapy (78.1% [95% CI, 75.2~80.7%]) had significantly higher eradication rates than the 7-day therapy (70.0% [95% CI, 68.5~71.4%]) (P<0.01). Conclusions These results suggest that the eradication rate of standard triple therapy, as the first-line therapy, has shown an unacceptable decrease. The eradication rate increased when the duration of therapy was increased to 14 days, but it was not satisfactory. Therefore, other treatment regimens or therapies based on susceptibility tests should be considered for the first-line therapy.http://www.helicojournal.org/upload/pdf/kjhugr-2020-0056.pdfclarithromycindisease eradicationmeta-analysis |
| spellingShingle | Seung Joo Kang Hye-Kyung Jung Yong Chan Lee Hyo-Joon Yang Seon-Young Park Cheol Min Shin Sung Eun Kim Hyun Chul Lim Jie-Hyun Kim Su Youn Nam Woon Geon Shin Jae Myung Park Il Ju Choi Jae Gyu Kim Miyoung Choi Eradication Rates of Clarithromycin Triple Therapy in Korea: A Systematic Review and Meta-analysis The Korean Journal of Helicobacter and Upper Gastrointestinal Research clarithromycin disease eradication meta-analysis |
| title | Eradication Rates of Clarithromycin Triple Therapy in Korea: A Systematic Review and Meta-analysis |
| title_full | Eradication Rates of Clarithromycin Triple Therapy in Korea: A Systematic Review and Meta-analysis |
| title_fullStr | Eradication Rates of Clarithromycin Triple Therapy in Korea: A Systematic Review and Meta-analysis |
| title_full_unstemmed | Eradication Rates of Clarithromycin Triple Therapy in Korea: A Systematic Review and Meta-analysis |
| title_short | Eradication Rates of Clarithromycin Triple Therapy in Korea: A Systematic Review and Meta-analysis |
| title_sort | eradication rates of clarithromycin triple therapy in korea a systematic review and meta analysis |
| topic | clarithromycin disease eradication meta-analysis |
| url | http://www.helicojournal.org/upload/pdf/kjhugr-2020-0056.pdf |
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