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Comparative Study
. 2000 Sep 16;321(7262):659-64.
doi: 10.1136/bmj.321.7262.659.

Systematic review and economic evaluation of Helicobacter pylori eradication treatment for non-ulcer dyspepsia. Dyspepsia Review Group

P Moayyedi  1 , S Soo, J Deeks, D Forman, J Mason, M Innes, B Delaney
Affiliations
Comparative Study

Systematic review and economic evaluation of Helicobacter pylori eradication treatment for non-ulcer dyspepsia. Dyspepsia Review Group

P Moayyedi et al. BMJ. .

Abstract

Objectives: To evaluate efficacy and cost effectiveness of Helicobacter pylori eradication treatment in patients with non-ulcer dyspepsia infected with H pylori.

Design: Systematic review of randomised controlled trials comparing H pylori eradication with placebo or another drug treatment. Results were incorporated into a Markov model comparing health service costs and benefits of H pylori eradication with antacid treatment over one year.

Data sources: Six electronic databases were searched for randomised controlled trials from January 1966 to May 2000. Experts in the field, pharmaceutical companies, and journals were contacted for information on any unpublished trials. Trial reports were reviewed according to predefined eligibility and quality criteria.

Main outcome measures: Relative risk reduction for remaining dyspeptic symptoms (the same or worse) at 3-12 months. Cost per dyspepsia-free month estimated from Markov model based on estimated relative risk reduction.

Results: Twelve trials were included in the systematic review, nine of which evaluated dyspepsia at 3-12 months in 2541 patients. H pylori eradication treatment was significantly superior to placebo in treating non-ulcer dyspepsia (relative risk reduction 9% (95% confidence interval 4% to 14%)), one case of dyspepsia being cured for every 15 people treated. H pylori eradication cost pound56 per dyspepsia-free month during first year after treatment.

Conclusion: H pylori eradication may be cost effective treatment for non-ulcer dyspepsia in infected patients but further evidence is needed on decision makers' willingness to pay for relief of dyspepsia.

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Figures

Figure 1
Figure 1
Forest plot of the nine trials comparing H pylori eradication treatment for non-ulcer dyspepsia with placebo
Figure 2
Figure 2
Cost effectiveness acceptability curve of H pylori eradication treatment for non-ulcer dyspepsia
See this image and copyright information in PMC

Comment in

References

    1. Hosking SW, Ling TK, Chung SC, Yung MY, Cheng AF, Sung JJ, et al. Duodenal ulcer healing by eradication of Helicobacter pylori without anti-acid treatment: randomised controlled trial. Lancet. 1994;343:508–510. - PubMed
    1. Talley NJ. A critique of therapeutic trials in Helicobacter pylori-positive functional dyspepsia. Gastroenterology. 1994;106:1174–1183. - PubMed
    1. Jaakkimainen RL, Boyle E, Tudiver F. Is Helicobacter pylori associated with non-ulcer dyspepsia and will eradication improve symptoms? A meta-analysis. BMJ. 1999;319:1040–1044. - PMC - PubMed
    1. Danesh J, Pounder RE. Eradication of Helicobacter pylori and non-ulcer dyspepsia. Lancet. 2000;355:766–767. - PubMed
    1. Laine L, Schoenfeld M, Fennerty B. H pylori is not effective for treatment of non-ulcer dyspepsia: meta-analysis of randomised controlled trials [abstract] Gastroenterology. 2000;118:A440.

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