P3333 - Efficacy and Safety of 10-day vs 14-day Bismuth-Containing Quadruple Therapy for H. pylori Eradication: A Systematic Review and Meta-Analysis

Muhammad Hammad Khan, MBBS¹, Najam Gohar, MBBS², Zoya Ejaz, MBBS³, Abdul Rafay Ahmed, MBBS⁴, Muhammad Abdullah Humayun, MBBS⁵, Momna Nisar, MBBS⁶, Muhammad Ali. Mushtaq, MBBS⁷, Fatima Zafar, MBBS⁸, Aanusha Ghouri, MBBS⁹, Sania Afzal, MBBS¹⁰, Hira Khalid, MBBS¹¹, Faizan Ahmed, MBBS¹², Rehmat Ullah Awan, MD¹³, Prasun K. Jalal, MBBS, MD^14
1King Edward Medical University, Lahore, Punjab, Pakistan; ²Ameer Ud Din Medical College, Lahore, Punjab, Pakistan; ³Jinnah Hospital, Lahore, Punjab, Pakistan; ⁴Lahore Medical and Dental College, Lahore, Punjab, Pakistan; ⁵Rawalpindi Medical University, Rawalpindi, Punjab, Pakistan; ⁶Allama Iqbal Medical College, Lahore, Punjab, Pakistan; ⁷Aga Khan Medical College, Karachi, Sindh, Pakistan; ⁸Services Hospital, Lahore, Punjab, Pakistan; ⁹Allama Iqbal Medical College, Upper Marlboro, MD; ¹⁰Punjab Medical College, Faisalabad, Punjab, Pakistan; ¹¹Shifa College of Medicine, Islamabad, Islamabad, Pakistan; ¹²Ameer Ud Din Medical College/ Lahore General Hospital, Lahore, Punjab, Pakistan; ¹³West Virginia University, Morgantown, WV; ¹⁴Baylor College of Medicine, Houston, TX

Introduction: Nearly half of the world population is infected by Helicobacter pylori (H. pylori). Currently, different treatment regimens are used for H. pylori eradication such as triple and quadruple therapy. Bismuth-containing quadruple therapy (BQT) has shown favorable outcomes. This study compares 10-day and 14-day BQT regimens to evaluate their efficacy, safety, and compliance rates.

Methods: We searched electronic databases from their inception until March 2024 to retrieve all randomized controlled trials (RCTs) that compared 10-day and 14-day BQT regimens for H. pylori eradication. Data about patients and study characteristics were extracted. Meta-analysis was performed using Review Manager 5.4. Dichotomous outcomes were compared using Risk Ratio (RR) and 95% Confidence Interval (CI), with a p-value < 0.05 considered significant.

Results: Seven RCTs and a total of 2,424 patients were included in the meta-analysis. The intention-to-treat eradication rates were 86.6%, for the 10-day BQT group and 90.3%.for the 14-day BQT. There was no significant difference between the eradication rate in the two groups (RR 0.97; 95% CI 0.94, 1.01). The per-protocol eradication rates were 90.8% for the 10-day BQT group and 96.0% for 14-day BQT. There was no significant difference between the eradication rate in the two groups (RR 0.96; 95% CI 0.93, 1.00). Commonly reported adverse events in both groups were epigastric pain and discomfort, nausea, and vomiting. There was no significant difference in the risk of adverse events between the two groups (RR 0.80; 95% CI 0.63, 1.02). The compliance rates were 94.6%, and 93.0% in the 10-day and 14-day groups, respectively. There was no significant difference in the compliance rate between the intervention and control groups (RR 1.02; 95% CI 1.00, 1.04).

Discussion: The eradication rates, risk of adverse events and compliance rates were comparable between the two groups. The non-inferiority of the 10-day BQT compared to the 14-day group has clinical and logistical implications. It allows physicians to prescribe the regimen keeping in mind other factors such as cost, availability of drugs, and patient preference and compliance. Future research comparing similar drug doses, with larger sample sizes and longer patient follow-up can improve the quality of results.


Disclosures:


Muhammad Hammad Khan, MBBS¹, Najam Gohar, MBBS², Zoya Ejaz, MBBS³, Abdul Rafay Ahmed, MBBS⁴, Muhammad Abdullah Humayun, MBBS⁵, Momna Nisar, MBBS⁶, Muhammad Ali. Mushtaq, MBBS⁷, Fatima Zafar, MBBS⁸, Aanusha Ghouri, MBBS⁹, Sania Afzal, MBBS¹⁰, Hira Khalid, MBBS¹¹, Faizan Ahmed, MBBS¹², Rehmat Ullah Awan, MD¹³, Prasun K. Jalal, MBBS, MD¹⁴. P3333 - Efficacy and Safety of 10-day vs 14-day Bismuth-Containing Quadruple Therapy for <i>H. pylori</i> Eradication: A Systematic Review and Meta-Analysis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.