Smoking Increases the Treatment Failure for Helicobacter pylori Eradication

Suzuki, Takeshi; Matsuo, Keitaro; Ito, Hidemi; Sawaki, Akira; Hirose, Kaoru; Wakai, Kenji; Sato, Shigeki; Nakamura, Tsuneya; Yamao, Kenji; Ueda, Ryuzo; Tajima, Kazuo

doi:10.1016/j.amjmed.2005.10.003

« Previous Next »The American Journal of Medicine
Volume 119, Issue 3 , Pages 217-224, March 2006

Smoking Increases the Treatment Failure for Helicobacter pylori Eradication

Takeshi Suzuki
- Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
- Department of Internal Medicine and Molecular Science, Nagoya City University Graduate School of Medical Science
Keitaro Matsuo
- Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
- Correspondence should be addressed to Keitaro Matsuo, MD, PhD, MSc, Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute 1-1 Kanokoden, Chikusa-ku Nagoya 464-8681, Japan Phone: +81-52-762-6111, Fax: +81-52-763-5233.
Hidemi Ito
- Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
Akira Sawaki
- Department of Gastroenterology, Aichi Cancer Center Central Hospital
Kaoru Hirose
- Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
Kenji Wakai
- Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
Shigeki Sato
- Department of Internal Medicine and Molecular Science, Nagoya City University Graduate School of Medical Science
Tsuneya Nakamura
- Department of Endoscopy, Aichi Cancer Center Central Hospital, Nagoya, Japan
Kenji Yamao
- Department of Gastroenterology, Aichi Cancer Center Central Hospital
Ryuzo Ueda
- Department of Internal Medicine and Molecular Science, Nagoya City University Graduate School of Medical Science
Kazuo Tajima
- Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan

Abstract

Purpose

Treatment failure for Helicobacter pylori (H. pylori) eradication is encountered in approximately 10-20% of patients, and many studies have pointed to a link with smoking. To investigate the effects of smoking on eradication outcome, we performed a meta-analysis.

Methods

A PubMed search was performed to retrieve articles published up to August 2005. Pooled odds ratio (OR) and differences rate for H. pylori eradication failure in smokers compared with nonsmokers were used as summary statistics. Meta-regression was used for examining the source of heterogeneity.

Results

Twenty-two published studies (5538 patients), which provided information on eradication failure according to smoking status, were included in the analysis. The summary OR for eradication failure among smokers relative to nonsmokers was 1.95 (95% confidence interval [CI]: 1.55-2.45; P <.01). It corresponds with the differences in eradication rates between smokers and nonsmokers (8.4% [95% CI: 3.3-13.5%, P <.01]). Meta-regression analysis demonstrated that a high proportion of nonulcer dyspepsia patients in studies revealed a higher failure rate among smokers, compared with a low proportion of nonulcer dyspepsia.