Search Results for: Helicobacter Pylori: algoritmo terapeutico di eradicazione

To the Editor We were excited to read the research article recently published in JAMA Oncology titled “Cancers Attributable to Infections in the US in 2017: A Meta-Analysis.” The meta-analysis of 128 studies aimed to determine the magnitude of the association between infections and cancer as well as the prevalence of infections in cancer cells. The authors found that in the US, human papillomavirus (n = 38 230) was responsible for the most cancers, followed by Helicobacter pylori (n = 10 624), hepatitis C virus (n = 9006), Epstein-Barr virus (n = 7581), hepatitis B virus (n = 2310), Merkel cell polyomavirus (n = 2000), Kaposi sarcoma–associated herpesvirus (n = 1075), and human T-cell lymphotropic virus type 1 (n = 659). Infections were estimated to be responsible for 4.3% of cancers diagnosed among adults in the US in 2017. However, we had some concerns with the methods of the meta-analysis.

Objectives
To compare the efficacy and safety of seven Chinese patent medicines (CPMs) combined with conventional triple/quadruple therapy (T/Q) for Helicobacter pylori-positive peptic ulcers.

Design
A systematic review and network meta-analysis.

Data sources
China National Knowledge Infrastructure, VIP database, Wanfang database, ScienceDirect, EBSCO, EMBASE, Web of Science, Cochrane Library and PubMed were searched through 1 June 2022.

Eligibility criteria
Randomised controlled trials (RCTs) testing CPMs combined with T/Q for H. pylori-positive peptic ulcers were included. The CPMs included Anweiyang capsule, Jianweiyuyang tablets/capsule/granule, Jinghuaweikang capsule, Kangfuxin liquid, Puyuanhewei capsule, Weifuchun tablets/capsule and Weisu granule. At least one of the following outcome indicators was recorded: complete ulcer healing rate (CUHR), effective rate (ER), H. pylori eradication rate (HPER), rate of peptic ulcer recurrence (RPUR) and incidence of adverse reactions (IAR).

Data extraction and synthesis
Two researchers independently conducted the study selection and extracted data for included studies. The risk of bias was assessed using the Cochrane risk of bias tool. A pairwise meta-analysis was performed using RevMan V.5.3. Network meta-analysis was performed using STATA/MP V.15.0. Confidence in the evidence was assessed using Grading of Recommendations, Assessment, Development and Evaluation.

Results
A total of 36 RCTs involving 3620 patients were included. Compared with T/Q alone, Weisu+T/Q, Weifuchun+T/Q and Puyuanhewei+T/Q had the highest CUHR, ER and HPER, respectively. Weisu+T/Q and Jianweiyuyang+T/Q had the lowest RPUR and IAR, respectively. The cluster analysis results showed Jianweiyuyang+T/Q might be the best choice concerning efficacy and safety simultaneously, followed by Kangfuxin+T/Q.

Conclusion
Among the combination therapies with the CPMs, Jianweiyuyang+T/Q might be the most favourable option for H. pylori-positive peptic ulcers, followed by Kangfuxin+T/Q. Considering the limited quantity and quality of the included RCTs, the results should be interpreted with caution.

PROSPERO registration number
CRD42022327687.

Sperimentale e terapeutico, è basato su Rna

We read the Maastricht VI/Florence consensus report published in GUT with great interest.1 The report suggested that vonoprazan-based therapy is superior, or not inferior, to conventional proton pump inhibitor (PPI)-based triple therapies for Helicobacter pylori eradication.1 However, the number of randomised controlled trials (RCTs) was small and the majority of previous trials were conducted in Japan.2–5 Recently, several new RCTs from other populations have been reported.6–8 Therefore, we conducted an updated systematic review and meta-analysis of RCTs to compare the efficacy and tolerability of vonoprazan and PPI-based therapies for H. pylori eradication. Detailed methods of the inclusion and exclusion criteria, systematic review, and statistical methods were shown in , and the registration number is CRD42023394825. Of the 489 articles identified, 476 articles were excluded (). A total of 13 RCTs were…

Your recent ‘Chinese Consensus Report on Family-based Helicobacter pylori infection Control and management (2021 Edition)’1 and ‘Large-scale, national, family-based epidemiological study on Helicobacter pylori infection in China: the time to change practice for related disease prevention’2 will encourage more doctors in China to consider Helicobacter pylori as a curable aetiology for gastrointestinal symptoms, and as a smart way to prevent gastric cancer in the ageing population. The paper is based on results of a very large new study of H. pylori prevalence in China whereby investigators completed a China-wide breath-test survey of 10 735 families. Unfortunately, 70% of families had at least one positive family member although younger, educated and Eastern-China families had less, with 28% of persons being infected but only 20% of children being infected. In contrast, some North-Western provinces had 85% of families infected and 19% had all family members infected. The parents…

Helicobacter pylori infection is associated with a decreased risk of esophageal adenocarcinoma, and the declining prevalence of such infection might contribute to the rising incidence of this tumor. We examined the hypothesis that eradication treatment of Helicobacter pylori increases the risk of esophageal adenocarcinoma.

Gravina: ‘Una medicina del sonno sempre più personalizzata’