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Effectiveness of Helicobacter pylori eradication in chronic urticaria: evidence-based analysis using the Grading of

Ali Shakouri1, Enrico Compalati, David M Lang

  • 1Department of Internal Medicine, Las Colinas Medical Center, Irving, Texas, USA. alishakouri@yahoo.com

Current Opinion in Allergy and Clinical Immunology
|July 9, 2010
PubMed

Insights

Eradicating Helicobacter pylori (H. pylori) for chronic urticaria management shows weak and conflicting evidence. The overall quality of evidence is very low, suggesting it should not be a routine treatment.

Area of Science:

  • Dermatology
  • Gastroenterology
  • Evidence-Based Medicine

Background:

  • Chronic urticaria is a prevalent condition with challenging management.
  • Exogenous causes are rarely identified.
  • Helicobacter pylori (H. pylori) has been proposed as a potential etiological factor for chronic urticaria.

Purpose of the Study:

  • To comprehensively review evidence on H. pylori eradication for chronic urticaria treatment.
  • To utilize the GRADE approach to assess the quality of evidence for this therapy.

Main Methods:

  • Critical appraisal of clinical trials investigating H. pylori eradication in chronic urticaria.
  • Application of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework.

Main Results:

  • Trials on H. pylori eradication for chronic urticaria have produced conflicting results.
  • Studies suffer from significant methodological limitations.
  • Evidence quality for H. pylori eradication improving chronic urticaria outcomes is rated as very low.

Conclusions:

  • The evidence supporting H. pylori eradication for chronic urticaria is weak and inconsistent.
  • A weak recommendation is made against routine H. pylori eradication for chronic urticaria.
  • Treatment decisions should weigh patient-specific factors, benefits, burdens, and preferences.
Abstract

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