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Review
. 2018 Oct 9:2018:6090878.
doi: 10.1155/2018/6090878. eCollection 2018.

Helicobacter pylori Eradication in Idiopathic Thrombocytopenic Purpura: A Meta-Analysis of Randomized Trials

Bum Jun Kim  1   2 , Hyeong Su Kim  1 , Hyun Joo Jang  3 , Jung Han Kim  1
Affiliations
Free PMC article
Review

Helicobacter pylori Eradication in Idiopathic Thrombocytopenic Purpura: A Meta-Analysis of Randomized Trials

Bum Jun Kim et al. Gastroenterol Res Pract. .
Free PMC article

Abstract

Objective: Several recent reviews of published studies have shown that the eradication of H. pylori infection in patients with ITP improved thrombocytopenia in about half of the cases. However, most included studies were observational case series. We performed the first meta-analysis of randomized trials to gain a better insight into the effect of H. pylori eradication in ITP patients.

Methods: A systematic computerized search of the electronic databases including PubMed, EMBASE, Google Scholar, and Cochrane Library (up to December 2017) was conducted.

Results: From six studies, a total of 241 patients (125 in eradication group and 116 in control group) were included in the meta-analysis. Patients in the eradication group showed significantly higher overall platelet response rate than those in the control group (odds ratio = 1.93, 95% confidence interval: 1.01-3.71, P = 0.05). In the subgroup analysis, however, children in the eradication group failed to show statistically better response rate than those in the noneradication group (odds ratio = 1.80, 95% confidence interval: 0.88-3.65, P = 0.11).

Conclusions: This meta-analysis indicates that H. pylori eradication has a significant therapeutic effect in patients with ITP. Considering the intrinsic limits in the design and sample size of the included studies, however, large randomized controlled trials are warranted to validate the therapeutic impact of H. pylori eradication in adults as well as children with ITP.

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Figures

Figure 1
Figure 1
Flow diagram of search process.
Figure 2
Figure 2
Forest plots of odds ratios for overall platelet response rates in all patients (a) and in children (b).
Figure 3
Figure 3
Funnel plot for publication bias regarding overall response rates.
See this image and copyright information in PMC

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