A systematic review of eradicating helicobacter pylori with ranitidine bismuth citrate_Chinese Journal of Evidence-Based Medicine

Authors：

WANG Yiping , WANG Qiong , TIAN Ling

Department of Gastroenterology; West China Hospital; Sichuan University; Chengdu 610041;

Corresponding author：

Keywords：

Ranitidine bismuth citrate; helicobacter pylori; systematic review; randomized controlled trials

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Objective 　To review the eradication rate for Helicobacter Pylori (H. pylori) eradication therapy with Ranitidine bismuth citrate (RBC).
Methods 　A systematic review of all the relevant randomized controlled trials (RCTs) was performed according to International Cochrane Collaboration. Data Source　RCTs were identified from specialized trials register of Cochrane U GDP Group, the Cochrane library, additional electronic search (including MEDLINE and CBM), handsearching, and personal contact with pharmaceutical companies.
Data Selection 　Randomized clinical trials comparing RBC or RBC in combination with other antibiotics such as proton pump inhibitor, H2-receptor antagonist, other bismuth or placebo were included. No language and blinding limitations were applied.
Inclusion criteria 　Data were extracted independently by two reviewers. The methodological quality of trials was assessed by the Jadad-scale plus allocation concealment. Statistics analysis was managed by using RevMan 4. 1.
Results 　Fifteen randomized clinical trials including 3 638 patients were included, with eight trials of high methodological quality. Meta-analysis indicated that odds ratio was 3.06 (95%CI 2.62 to 3. 58, P lt; 0. 000 01) comparing RBC to controls. But the heterogeneity was significant (P lt; 0. 000 01), so we choose random effects model. Then the odds ratio was 2.05 (95%CI 1. 29 to 3. 25, P=0.002). No serious adverse effects were found. Sensitivity analysis showed that the specimens and the quality of RCT haven’t affected researching result.
Conclusion 　RBC is more effective in Helicobacter Pylori eradication therapy than others.

Citation： WANG Yiping,WANG Qiong,TIAN Ling. A systematic review of eradicating helicobacter pylori with ranitidine bismuth citrate. Chinese Journal of Evidence-Based Medicine, 2003, 03(2): 98-107. doi: Copy

1.	［1］中华医学会消化病学分会.幽门螺杆菌若干问题的共识意见[J]中华消化杂志2000;20(2):117-118.Branch of Gastroenterology , Medicine Association of China. The unanimous opinion about some problem of H. Pylor [J]. Gas-trotroenteric magazine of China. 2002;20(2):117- 118.
2.	［2］urrent concepts in the management of Helicobacter pylori infection The Maastricht 2 - 2000 Consensus Report. Aliment [J]. Pharmacol Ther 2002; 16 (2): 167- 180.
3.	［3］Van Oijen A H, Verbeek A L, Jansen J B, et al. Review article: treatment of heliconbacter pylori infection with Ranitidine bithmuth citrate- or proton pump inhibitor- based triple therapies. Aliment Phamacol Ther 2000; 16 (8): 991 - 999.
4.	［4］Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of Randomized clinical trials: is blinding necessary [J]?Control Clin Trials 1996; 17:1 - 12.
5.	［5］Danese S, Armuz zi A, Romano A, et al. Efficacy and tolerability of antibiotics in patients undergoing H. Pylori eradication [J].Hepatogastroenterology 2001; 48 (38): 465 - 467.
6.	［6］Savarino V, Zentilin P, Pivari M, et al. The impact of antibioticresistanee on the efficacy of three 7 - day regimens against Helicobacter pylor [J]. Aliment Pharmacol Ther 2000; 14 (7): 893- 900.
7.	［7］Pare P, Farley A, Romaozinho JM, et al. Coomparison of Ritidine bismuth citrate plus Crithromycin with Oprazole plus Crithromycin for the eradication of Helicobacter pylor [J ]. Aliment PharmacolTher 1999; 13 (8): 1071 - 1078.
8.	［8］catalano F, Catanzaro R, Bentivegina C, et al. Ritidine bismuth citrate versus Oprazole triple therapy for the eradication of Helicobacter pylori and healing of duodenal ulcer. Aliment [J ]. Pharmacol Ther 1998; 12 (1): 59-62.
9.	［9］上海市瑞倍临床试验协作组.枸橼酸铋雷尼替丁为主三联1周方案根除H. pylori方案的研究.中华消化杂志2001:2:124-125Association Groupof clinicalTrials,Rui-Pei,Shang-hai.The Research about eradication .H. Pylori with ranitidine Bismuth Citrate. Gastroenteric magazine of China. 2001 ;2:124 - 125.
10.	［10］Kung NN, Sung JJ, Yuen NW, et al. One week R anitidine bismuth citrate versus colloidal bismuth subcitrate based anti Helicobacter triple therapy: a prospective Randomized controlled trial [J]. Am J Gastroenterol 1999; 94 (3): 721-724.
11.	［11］方秀才陆星华董恩钰国产枸橼酸铋雷尼替丁治疗消化性溃疡的临床研究中国临床药理杂志2001;1:3-6FangXiu cai, lu Xing hua , Dong En- yu. The clinical re-search of Eradicating gastroenteritic ulceration with RBC made inchina. Clinical Pharmacological Magazine of China. 2001; 1:3-6.
12.	［12］沈磊,罗和生,沈志祥等.雷尼替丁枸橼酸铋三联治疗H.pvlori相关性消化性溃疡疗效观察.胃肠病学2001;6:增刊.Shen Lei, Luo He-sheng, Shen Zhi-xiang. The observe of Curative effect of relativity Gastroenteritic ulceration with RBC Gastroenterology. 2001 ;6: supplement.
13.	［13］catalano F, BRciforte G, Catanzaro R, et al. Helicobacter pylori - positive duodenal ulcer: three - day antibiotic eradication regi men [J]. Aliment Pharmacol Ther 2000; 14 (10):1329-1334.
14.	［14］Mao HV, Lack BV, Long T, et al. Oprazole or Ranitidine hismuth citrate triple therapy to treat Helicobacter pylori infection: a Randomized, controlled trial in Vietnamese patients with duo denal ulcer [J]. Aliment Pharmacol Ther 2000; 14 (1): 97-101.
15.	［15］Spadaecini A, De Fanis C, Sciampa G, et al. Triple regimens using Lsoprazole or Ranitidine bismuth citrate for Helicobacter pylori eradication [J]. Aliment Pharmacol Ther 1998; 12 ( 10): 997- 1001.
16.	［16］SungJ.J., LeungW. K, LingT. K. et al. One-week use of Ritidine bismuth citrate, axycillin and Crithromycin for the treat ment of Helicobacter pylori - related duodenal ulcer. Aliment Pharmacol Ther 1998; 12 (8): 725 - 730.
17.	［17］Kolkman J. J, Tan T. G, Oudkerk Pool M, et al. Ritidine bis muth citrate with Crithromycin versus Oprazole with Axycillin in the cure of Helicobacter pylori infection [J ]. Aliment Phamacol Ther1997; 11 (6): 1123-1129.
18.	［18］Peterson W. L, Ciociola A. A, Sykes D. L, et al. Ritidine bis muth citrate plus Crithromycin is effective for healing duodenal ulcers, eradicaTg H. pylori and reducing ulcer recurrence [J]. Aliment Pharrmacol Ther 1996; 11 (2): 251 - 261.
19.	［19］Bardhan K.D, DekkersC. P.M, LarmS. K, etal. GR122311 (Ritidine bismuth citrate), a new drug for the treatment of duo denal ulcer [J]. Aliment Pharmacol Ther 1995; 9 (7): 497-506.
20.	［20］Vondracek TG. Ranitidine bismuth citrate in the treatment of he licobacter pylori infection and duodenal ulcer [J ]. Annals Pharmacol Ther 1998; 32: 672- 679.

1. ［1］中华医学会消化病学分会.幽门螺杆菌若干问题的共识意见[J]中华消化杂志2000;20(2):117-118.Branch of Gastroenterology , Medicine Association of China. The unanimous opinion about some problem of H. Pylor [J]. Gas-trotroenteric magazine of China. 2002;20(2):117- 118.
2. ［2］urrent concepts in the management of Helicobacter pylori infection The Maastricht 2 - 2000 Consensus Report. Aliment [J]. Pharmacol Ther 2002; 16 (2): 167- 180.
3. ［3］Van Oijen A H, Verbeek A L, Jansen J B, et al. Review article: treatment of heliconbacter pylori infection with Ranitidine bithmuth citrate- or proton pump inhibitor- based triple therapies. Aliment Phamacol Ther 2000; 16 (8): 991 - 999.
4. ［4］Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of Randomized clinical trials: is blinding necessary [J]?Control Clin Trials 1996; 17:1 - 12.
5. ［5］Danese S, Armuz zi A, Romano A, et al. Efficacy and tolerability of antibiotics in patients undergoing H. Pylori eradication [J].Hepatogastroenterology 2001; 48 (38): 465 - 467.
6. ［6］Savarino V, Zentilin P, Pivari M, et al. The impact of antibioticresistanee on the efficacy of three 7 - day regimens against Helicobacter pylor [J]. Aliment Pharmacol Ther 2000; 14 (7): 893- 900.
7. ［7］Pare P, Farley A, Romaozinho JM, et al. Coomparison of Ritidine bismuth citrate plus Crithromycin with Oprazole plus Crithromycin for the eradication of Helicobacter pylor [J ]. Aliment PharmacolTher 1999; 13 (8): 1071 - 1078.
8. ［8］catalano F, Catanzaro R, Bentivegina C, et al. Ritidine bismuth citrate versus Oprazole triple therapy for the eradication of Helicobacter pylori and healing of duodenal ulcer. Aliment [J ]. Pharmacol Ther 1998; 12 (1): 59-62.
9. ［9］上海市瑞倍临床试验协作组.枸橼酸铋雷尼替丁为主三联1周方案根除H. pylori方案的研究.中华消化杂志2001:2:124-125Association Groupof clinicalTrials,Rui-Pei,Shang-hai.The Research about eradication .H. Pylori with ranitidine Bismuth Citrate. Gastroenteric magazine of China. 2001 ;2:124 - 125.
10. ［10］Kung NN, Sung JJ, Yuen NW, et al. One week R anitidine bismuth citrate versus colloidal bismuth subcitrate based anti Helicobacter triple therapy: a prospective Randomized controlled trial [J]. Am J Gastroenterol 1999; 94 (3): 721-724.
11. ［11］方秀才陆星华董恩钰国产枸橼酸铋雷尼替丁治疗消化性溃疡的临床研究中国临床药理杂志2001;1:3-6FangXiu cai, lu Xing hua , Dong En- yu. The clinical re-search of Eradicating gastroenteritic ulceration with RBC made inchina. Clinical Pharmacological Magazine of China. 2001; 1:3-6.
12. ［12］沈磊,罗和生,沈志祥等.雷尼替丁枸橼酸铋三联治疗H.pvlori相关性消化性溃疡疗效观察.胃肠病学2001;6:增刊.Shen Lei, Luo He-sheng, Shen Zhi-xiang. The observe of Curative effect of relativity Gastroenteritic ulceration with RBC Gastroenterology. 2001 ;6: supplement.
13. ［13］catalano F, BRciforte G, Catanzaro R, et al. Helicobacter pylori - positive duodenal ulcer: three - day antibiotic eradication regi men [J]. Aliment Pharmacol Ther 2000; 14 (10):1329-1334.
14. ［14］Mao HV, Lack BV, Long T, et al. Oprazole or Ranitidine hismuth citrate triple therapy to treat Helicobacter pylori infection: a Randomized, controlled trial in Vietnamese patients with duo denal ulcer [J]. Aliment Pharmacol Ther 2000; 14 (1): 97-101.
15. ［15］Spadaecini A, De Fanis C, Sciampa G, et al. Triple regimens using Lsoprazole or Ranitidine bismuth citrate for Helicobacter pylori eradication [J]. Aliment Pharmacol Ther 1998; 12 ( 10): 997- 1001.
16. ［16］SungJ.J., LeungW. K, LingT. K. et al. One-week use of Ritidine bismuth citrate, axycillin and Crithromycin for the treat ment of Helicobacter pylori - related duodenal ulcer. Aliment Pharmacol Ther 1998; 12 (8): 725 - 730.
17. ［17］Kolkman J. J, Tan T. G, Oudkerk Pool M, et al. Ritidine bis muth citrate with Crithromycin versus Oprazole with Axycillin in the cure of Helicobacter pylori infection [J ]. Aliment Phamacol Ther1997; 11 (6): 1123-1129.
18. ［18］Peterson W. L, Ciociola A. A, Sykes D. L, et al. Ritidine bis muth citrate plus Crithromycin is effective for healing duodenal ulcers, eradicaTg H. pylori and reducing ulcer recurrence [J]. Aliment Pharrmacol Ther 1996; 11 (2): 251 - 261.
19. ［19］Bardhan K.D, DekkersC. P.M, LarmS. K, etal. GR122311 (Ritidine bismuth citrate), a new drug for the treatment of duo denal ulcer [J]. Aliment Pharmacol Ther 1995; 9 (7): 497-506.
20. ［20］Vondracek TG. Ranitidine bismuth citrate in the treatment of he licobacter pylori infection and duodenal ulcer [J ]. Annals Pharmacol Ther 1998; 32: 672- 679.

Chinese Journal of Evidence-Based Medicine

A systematic review of eradicating helicobacter pylori with ranitidine bismuth citrate

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