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Errors in a Meta-analysis of Treatments for Helicobacter pylori Infection
Nadim S. Jafri, MD, and
Colin W. Howden, MD
4 November 2008 | Volume 149 Issue 9 | Page 686
IN RESPONSE:
We thank Dr. Gatta and colleagues for their comments. Our rationale for including the trial that had used a regimen of ranitidinebismuthcitrate (1) is given in our article. However, a sensitivity analysis had excluded that trial by examining only studies that had compared 10 days of sequential treatment with 7 days of triple therapy (Table 3). Inclusion or exclusion of that trial did not substantially alter our results.
Regarding the issue of clarithromycin-resistant strains in the study by De Francesco and colleagues (2), Gatta and colleagues are correct. We regret our error in the transcription of these data. The corrected analysis still demonstrates an advantage of sequential over triple therapy.
We apologize for the erroneous assumption that 2 trials (3, 4) had included patients from a U.S. site. The fact that none of the trials had included U.S. patients underscores our recommendation that sequential treatment should be studied in randomized, controlled trials in the United States.
Annals recently published an erratum to correct these errors (5).
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Author and Article Information
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From Baylor College of Medicine, Houston, TX 77030, and Northwestern University Feinberg School of Medicine, Chicago, IL 60611.
Potential Financial Conflicts of Interest: Consultancies: C.W. Howden (Meretek, TAP, Takeda, Santarus, and Novartis). Honoraria: C.W. Howden (AstraZeneca, Meretek, and Santarus). Grants received: C.W. Howden (AstraZeneca).
1. De Francesco V, Zullo A, Hassan C, Faleo D, Ierardi E, Panella C. Two new treatment regimens for Helicobacter pylori eradication: a randomised study. Dig Liver Dis. 2001;33:676-9. [PMID: 11785713].[Medline]
2. De Francesco V, Margiotta M, Zullo A, Hassan C, Troiani L, Burattini O. Clarithromycin-resistant genotypes and eradication of Helicobacter pylori. Ann Intern Med. 2006;144:94-100. [PMID: 16418408].[Abstract/Free Full Text]
3. Vaira D, Zullo A, Vakil N, Gatta L, Ricci C, Perna F. Sequential therapy versus standard triple-drug therapy for Helicobacter pylori eradication: a randomized trial. Ann Intern Med. 2007;146:556-63. [PMID: 17438314].[Abstract/Free Full Text]
4. Zullo A, Vaira D, Vakil N, Hassan C, Gatta L, Ricci C. High eradication rates of Helicobacter pylori with a new sequential treatment. Aliment Pharmacol Ther. 2003;17:719-26. [PMID: 12641522].[Medline]
5. Correction: sequential therapy appears superior to standard therapy for Helicobacter pylori infection in patients naive to treatment [Letter]. Ann Intern Med. 2008;149:439.[Free Full Text]
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Articles
Clarithromycin-Resistant Genotypes and Eradication of Helicobacter pylori
Vincenzo De Francesco, Marcella Margiotta, Angelo Zullo, Cesare Hassan, Laura Troiani, Osvaldo Burattini, Francesca Stella, Alfredo Di Leo, Francesco Russo, Stefania Marangi, Rosa Monno, Vincenzo Stoppino, Sergio Morini, Carmine Panella, AND Enzo Ierardi
- Annals 2006 144: 94-100.
[ABSTRACT][Full Text]
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