Helicobacter Pylori Eradication or Antisecretory Therapy for Rebleeding from Peptic Ulcer

A Cochrane review (abstract , review [Abstract]) included 10 studies with a total of 1 048 patients. In the first meta-analysis (7 studies, 578 patients), mean percentage of rebleeding in H. pylori eradication therapy group was 2.9%, and in the non-eradication therapy group without subsequent long-term maintenance antisecretory therapy it was 20% (OR 0.17, 95% CI 0.10 to 0.32; there was no statistical evidence of heterogeneity; NNT was 7, 95% CI 5 to 11). In the second meta-analysis (3 studies, 470 patients), mean percentage of rebleeding in H. pylori eradication group was 1.6%, compared to 5.6% in antisecretory therapy group with long-term maintenance (OR 0.25, 95% CI 0.08 to 0.76; NNT = 20, 95% CI 12 to 100).

The following decision support rules contain links to this evidence summary:

• Helicobacter eradication in patients with a bleeding ulcer http://www.ebmeds.org/ebmeds/ebmeds_home.asp?mode=scripts&submode=view&id=scr00509&country=UK

References

• Gisbert JP, Khorrami S, Carballo F, Calvet X, Gené E, Dominguez-Muñoz JE. H. pylori eradication therapy vs. antisecretory non-eradication therapy (with or without long-term maintenance antisecretory therapy) for the prevention of recurrent bleeding from peptic ulcer. Cochrane Database Syst Rev 2004;(2):CD004062. [PubMed]