Theodore Rokkas,Konstantinos Ekmektzoglou,Yaron Niv,David Y Graham
{"title":"基于钾竞争性酸阻滞剂(P-CAB)的双联、三联和四联方案治疗幽门螺杆菌感染一线疗程的疗效和安全性比较:系统综述和网络荟萃分析。","authors":"Theodore Rokkas,Konstantinos Ekmektzoglou,Yaron Niv,David Y Graham","doi":"10.14309/ajg.0000000000003084","DOIUrl":null,"url":null,"abstract":"BACKGROUND AIMS\r\nIn the last few years numerous new P-CAB based RCTs concerning first-line regimens for H. pylori infection treatment from various countries have been published. However, no NWM exists which examines the comparative efficacy and safety of P-CAB based dual, triple and quadruple treatments and therefore, in this network meta-analysis (NWM) we examined this matter comparing efficacy and safety of these P-CAB based regimens.\r\n\r\nMETHODS\r\nDatabases were searched for identification, screening, eligibility and inclusion of relevant randomized controlled trials (RCTs). Extracted data were entered into a Bayesian NWM and the ranking order for each regimen was evaluated by means of surfaces under cumulative ranking area (SUCRA) values.\r\n\r\nRESULTS\r\nTwenty-five eligible RCTs were included with 7,605 patients randomized to 6 first line regimens, i.e. PCAB-DUAL, PCAB-TRIPLE, PCAB-QUADRUPLE, PPI-DUAL, PPI-TRIPLE, and PPI- QUADRUPLE. The SUCRA values (%) for these 6 regimens were 92.7, 62.5, 33.9, 75.1, 19.4 and 16.3 respectively. The comparative effectiveness ranking showed that PCAB-DUAL regimen ranked first for efficacy and last for adverse effects and had the best profile for integrated efficacy-safety.\r\n\r\nCONCLUSIONS\r\nIn this NWM concerning the comparative efficacy and safety of P-CAB based dual, triple and quadruple regimens for first line H. pylori infection treatment, the overall results showed that PCAB based dual treatment ranked first for efficacy with the best-integrated efficacy-safety profile. This is of importance, since the dual regimens overcome the crucial issue of clarithromycin resistance. Consequently, these findings are expected to be useful in helping clinical decision-making and future guidelines.","PeriodicalId":520099,"journal":{"name":"The American Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparative efficacy and safety of Potassium-Competitive Acid Blocker (P-CAB) based dual, triple and quadruple regimens for first line H. pylori infection treatment: A systematic review and network meta-analysis.\",\"authors\":\"Theodore Rokkas,Konstantinos Ekmektzoglou,Yaron Niv,David Y Graham\",\"doi\":\"10.14309/ajg.0000000000003084\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"BACKGROUND AIMS\\r\\nIn the last few years numerous new P-CAB based RCTs concerning first-line regimens for H. pylori infection treatment from various countries have been published. However, no NWM exists which examines the comparative efficacy and safety of P-CAB based dual, triple and quadruple treatments and therefore, in this network meta-analysis (NWM) we examined this matter comparing efficacy and safety of these P-CAB based regimens.\\r\\n\\r\\nMETHODS\\r\\nDatabases were searched for identification, screening, eligibility and inclusion of relevant randomized controlled trials (RCTs). Extracted data were entered into a Bayesian NWM and the ranking order for each regimen was evaluated by means of surfaces under cumulative ranking area (SUCRA) values.\\r\\n\\r\\nRESULTS\\r\\nTwenty-five eligible RCTs were included with 7,605 patients randomized to 6 first line regimens, i.e. PCAB-DUAL, PCAB-TRIPLE, PCAB-QUADRUPLE, PPI-DUAL, PPI-TRIPLE, and PPI- QUADRUPLE. The SUCRA values (%) for these 6 regimens were 92.7, 62.5, 33.9, 75.1, 19.4 and 16.3 respectively. The comparative effectiveness ranking showed that PCAB-DUAL regimen ranked first for efficacy and last for adverse effects and had the best profile for integrated efficacy-safety.\\r\\n\\r\\nCONCLUSIONS\\r\\nIn this NWM concerning the comparative efficacy and safety of P-CAB based dual, triple and quadruple regimens for first line H. pylori infection treatment, the overall results showed that PCAB based dual treatment ranked first for efficacy with the best-integrated efficacy-safety profile. This is of importance, since the dual regimens overcome the crucial issue of clarithromycin resistance. Consequently, these findings are expected to be useful in helping clinical decision-making and future guidelines.\",\"PeriodicalId\":520099,\"journal\":{\"name\":\"The American Journal of Gastroenterology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-09-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"The American Journal of Gastroenterology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.14309/ajg.0000000000003084\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"The American Journal of Gastroenterology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.14309/ajg.0000000000003084","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Comparative efficacy and safety of Potassium-Competitive Acid Blocker (P-CAB) based dual, triple and quadruple regimens for first line H. pylori infection treatment: A systematic review and network meta-analysis.
BACKGROUND AIMS
In the last few years numerous new P-CAB based RCTs concerning first-line regimens for H. pylori infection treatment from various countries have been published. However, no NWM exists which examines the comparative efficacy and safety of P-CAB based dual, triple and quadruple treatments and therefore, in this network meta-analysis (NWM) we examined this matter comparing efficacy and safety of these P-CAB based regimens.
METHODS
Databases were searched for identification, screening, eligibility and inclusion of relevant randomized controlled trials (RCTs). Extracted data were entered into a Bayesian NWM and the ranking order for each regimen was evaluated by means of surfaces under cumulative ranking area (SUCRA) values.
RESULTS
Twenty-five eligible RCTs were included with 7,605 patients randomized to 6 first line regimens, i.e. PCAB-DUAL, PCAB-TRIPLE, PCAB-QUADRUPLE, PPI-DUAL, PPI-TRIPLE, and PPI- QUADRUPLE. The SUCRA values (%) for these 6 regimens were 92.7, 62.5, 33.9, 75.1, 19.4 and 16.3 respectively. The comparative effectiveness ranking showed that PCAB-DUAL regimen ranked first for efficacy and last for adverse effects and had the best profile for integrated efficacy-safety.
CONCLUSIONS
In this NWM concerning the comparative efficacy and safety of P-CAB based dual, triple and quadruple regimens for first line H. pylori infection treatment, the overall results showed that PCAB based dual treatment ranked first for efficacy with the best-integrated efficacy-safety profile. This is of importance, since the dual regimens overcome the crucial issue of clarithromycin resistance. Consequently, these findings are expected to be useful in helping clinical decision-making and future guidelines.