Systematic review : Third-line susceptibility-guided treatment for Helicobacter pylori infection
Puig, Ignasi (Universitat Autònoma de Barcelona. Departament de Medicina)
López Góngora, Sheila (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Calvet Calvo, Xavier (Universitat Autònoma de Barcelona. Departament de Medicina.)
Villoria, Albert (Universitat Autònoma de Barcelona. Departament de Medicina)
Baylina i Melé, Mireia (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Sánchez-Delgado, Jordi (Universitat Autònoma de Barcelona. Departament de Medicina)
Suarez, David (Instituto de Investigación Hospital Universitario de la Princesa)
García Hernando, Victor (Universitat Autònoma de Barcelona. Departament de Medicina)
P. Gisbert, Javier (Instituto de Investigación Hospital Universitario de la Princesa)

Data:	2016
Resum:	Background: Susceptibility-guided therapies (SGTs) have been proposed as preferable to empirical rescue treatments after two treatment failures. The aim of this study was to perform a systematic review and meta-analysis evaluating the effectiveness and efficacy of SGT as third-line therapy. Methods: A systematic search was performed in multiple databases. Studies reporting cure rates of Helicobacter pylori with SGT in third-line therapy were selected. A qualitative analysis describing the current evidence and a pooled mean analysis summarizing the cure rates of SGT in third-line therapy was performed. Results: No randomized controlled trials or comparative studies were found. Four observational studies reported cure rates with SGT in third-line treatment, and three studies which mixed patients with second- and third-line treatment also reported cure rates with SGT. The majority of the studies included the patients when culture had been already obtained, and so the effectiveness of SGT and empirical therapy has never been compared. A pooled mean analysis including four observational studies (283 patients) showed intention-to-treat and per-protocol eradication rates with SGT of 72% (95% confidence interval 56-87%; I: 92%) and 80% (95% confidence interval 71-90%; I: 80%), respectively. Conclusions: SGT may be an acceptable option as rescue treatment. However, cure rates are, at best, moderate and this approach has never been compared with a well-devised empirical therapy. The evidence in favor of SGT as rescue therapy is currently insufficient to recommend its use.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Publicat a:	Therapeutic Advances in Gastroenterology, Vol. 9, Núm. 4 (January 2016) , p. 437-448, ISSN 1756-2848

DOI: 10.1177/1756283X15621229
PMID: 27366212

12 p, 216.0 KB

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Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut d’Investigació i Innovació Parc Taulí (I3PT)
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