LITTLE SUPPORT EXISTS FOR THE USE OF HELICOBACTER PYLORI ERADICATION THERAPY IN PATIENTS WITH NONULCER DYSPEPSIA.

Laine L, Schoenfeld P, Fennerty B: Therapy for Helicobacter pylori in patients with nonulcer dyspepsia. Ann Intern Med 2001;134:361-369

This meta-analysis included searches of bibliographic databases, reviews of proceedings of annual gastroenterology and Helicobacter pylori meetings from 1995 to 1999, reviews of reference lists, and contact with primary investigators and pharmaceutical manufacturers. The 10 studies that were included met the following criteria: study patients had nonulcer dyspepsia and H pylori infection; combination therapy for H pylori and a control therapy without efficacy against H pylori were used; trials were randomized and controlled; a duration of at least 1 month after therapy was included; and symptoms of nonulcer dyspepsia were assessed. The odds ratio (OR) for treatment success in nonulcer dyspepsia with H pylori eradication therapy versus the control therapy was 1.29 (95% CI, 0.89-1.89; P = .18). Significant heterogeneity (P = .04), however, calls the validity of aggregating the data into question. Heterogeneity resolved with the elimination of one study (OR, 1.07 [CI, 0.83-1.371; P[greater than].2). The OR was 1 .04 (CI, 0.80-1.35) for predefined analysis of trials that used a specifically stated definition of dyspepsia without heterogeneity.