Helicobacter Pylori Eradication For Iron-Deficiency Anemia-A Meta-analysis

Part OneHelicobacter pylori Eradication for Iron-Deficiency Anemia-A Meta-analysisBACKGROUND Helicobacter pylori infection and iron deficiency anemia are prevalent in disadvantaged populations worldwide. The benefit of Helicobacter pylori eradiation for iron deficiency anemia has been extensively studied, but data are still equivocal.METHODS A search in The Cochrane Library, PUBMED, EMBASE, EBM Review databases, Science Citation Index Expanded, and CMB (Chinese Biomedical Literature Database) was performed. Randomized controlled trials (RCTs) comparing anti-Helicobacter pylori plus oral iron to oral iron alone for the iron deficiency patients in whom Helicobacter pylori was positive were selected for meta-analysis. Reviev Manager 5.0 software was used for the performance of meta-analysis.RESULTS Sixteen randomized controlled trials totaling 956 patients were included. The meta-analysis showed that the difference from baseline to endpoint of hemoglobin (Hb), serum iron (SI), and serum ferritin (SF) was statistically significantly different between anti-Helicobacter pylori treatment plus oral iron and oral iron alone (SMD, Hb 1.48; 95%CI,0.96,2.00; P<0.00001; 'SI 1.15; 95%CI,0.87,1.43; P<0.00001; SF 1.84; 95%CI,1.20,2.48; P<0.00001; respectively).CONCLUSIONS Our study suggests that treatment of Helicobacter pylori infection could be effective in improving anemia and iron statue in IDA patients infected by Helicobacter pylori, particularly in patients with moderate or severe anemia. Part TwoMoxifloxacin-based triple therapy versus clarithromycin-based triple therapy for first-line treatment of Helicobacter pylori infection:A Meta-Analysis of Randomized Controlled TtrialsBackground Moxifloxacin-based triple therapy has been suggested as an alternative first line therapy to clarithromycin-based triple therapy for Helicobacter pylori (H. pylori) infection.Aims To systematically review the efficacy and tolerance of moxifloxacin-based triple therapy, and to conduct a meta-analysis of studies comparing these regimens with clarithromycin-based triple therapy.Methods A search of in The Cochrane Library, PUBMED, EMBASE, EBM Review databases, Science Citation Index Expanded, CMB (Chinese Biomedical Literature Database) and CNKI (China National Knowledge Infrastructure) was performed. Randomized controlled trials (RCTs) comparing moxifloxacin-based triple therapy to gold standard triple therapy in the first-line treatment of Helicobacter pylori infection were selected for meta-analysis. Relative risk (RR) was used as a measure of the effect of two regimens mentioned above with a fixed-effects model using the methods of DerSimonian and Laird.Results Four randomized controlled trials totaling 772 patients were included. The meta-analysis showed that the eradication rate was statistically significantly different between moxifloxacin-based triple therapy and clarithromycin-based triple therapy (RR,1.13; 95%CI,1.01,1.27;P=0.04); and there were no statistically significantly different in overall side effects (RR,0.61; 95% CI,0.25,1.48; P<0.28).Conclusions Moxifloxacin-based triple therapy is more effective and better tolerated than clarithromycin-based triple therapy in the treatment of H. pylori infection. Part ThreeMoxifloxacin-based triple therapy versus standard quadruple regimens for second-line treatment of Helicobacter pylori infection:A Meta-Analysis of Randomized Controlled TrialsBackground Moxifloxacin-based triple therapy has been suggested as an alternative therapy to current recommended salvage therapy for Helicobacter pylori (H. pylori) infection.Aims To systematically review the efficacy and tolerance of moxifloxacin-based triple therapy, and to conduct a meta-analysis of studies comparing standard quadruple regimens for second-line treatment of Helicobacter pylori infection.Methods A search of in The Cochrane Library, PUBMED, EMBASE, EBM Review databases, Science Citation Index Expanded, and CMB (Chinese Biomedical Literature Database) was performed. Randomized controlled trials (RCTs) comparing moxifloxacin-based triple therapy to standard quadruple therapy in the second-line treatment of Helicobacter pylori infection were selected for meta-analysis. Relative risk (RR) was used as a measure of the effect of two regimens mentioned above with a fixed-effects model using the methods of DerSimonian and Laird.Results Four randomized controlled trials totaling 519 patients were included. The meta-analysis showed that the eradication rate was statistically significantly different (RR,1.08; 95%CI,1.14, 1.34; P=0.01); and the incidence of overall side effects was also statistically different (RR,0.39; 95% CI,0.27,0.57; P<0.00001) between moxifloxacin-based triple therapy and standard quadruple therapy.Conclusions Moxifloxacin-based triple therapy is more effective and better tolerated than standard quadruple therapy in the second-line treatment of H. pylori infection.