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Helicobacter pylori eradication therapy for functional dyspepsia: Systematic
review and meta-analysis
#MMPMID27022230
Du LJ
; Chen BR
; Kim JJ
; Kim S
; Shen JH
; Dai N
World J Gastroenterol
2016[Mar]; 22
(12
): 3486-95
PMID27022230
show ga
AIM: To evaluate whether Helicobacter pylori (H. pylori) eradication therapy
benefits patients with functional dyspepsia (FD). METHODS: Randomized controlled
trials (RCTs) investigating the efficacy and safety of H. pylori eradication
therapy for patients with functional dyspepsia published in English (up to May
2015) were identified by searching PubMed, EMBASE, and The Cochrane Library.
Pooled estimates were measured using the fixed or random effect model. Overall
effect was expressed as a pooled risk ratio (RR) or a standard mean difference
(SMD). All data were analyzed with Review Manager 5.3 and Stata 12.0. RESULTS:
This systematic review included 25 RCTs with a total of 5555 patients with FD.
Twenty-three of these studies were used to evaluate the benefits of H. pylori
eradication therapy for symptom improvement; the pooled RR was 1.23 (95%CI:
1.12-1.36, P < 0.0001). H. pylori eradication therapy demonstrated symptom
improvement during long-term follow-up at ? 1 year (RR = 1.24; 95%CI: 1.12-1.37,
P < 0.0001) but not during short-term follow-up at < 1 year (RR = 1.26; 95%CI:
0.83-1.92, P = 0.27). Seven studies showed no benefit of H. pylori eradication
therapy on quality of life with an SMD of -0.01 (95%CI: -0.11 to 0.08, P = 0.80).
Six studies demonstrated that H. pylori eradication therapy reduced the
development of peptic ulcer disease compared to no eradication therapy (RR =
0.35; 95%CI: 0.18-0.68, P = 0.002). Eight studies showed that H. pylori
eradication therapy increased the likelihood of treatment-related side effects
compared to no eradication therapy (RR = 2.02; 95%CI: 1.12-3.65, P = 0.02). Ten
studies demonstrated that patients who received H. pylori eradication therapy
were more likely to obtain histologic resolution of chronic gastritis compared to
those who did not receive eradication therapy (RR = 7.13; 95%CI: 3.68-13.81, P <
0.00001). CONCLUSION: The decision to eradicate H. pylori in patients with
functional dyspepsia requires individual assessment.
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