Meta-analysis: efficacy of bovine lactoferrin in Helicobacter pylori eradication.

BACKGROUND Several randomized-controlled trials (RCTs) have sought to determine the efficacy of bovine lactoferrin in Helicobacter pylori eradication with equivocal results. AIM To evaluate the effect of bovine lactoferrin supplementation in H. pylori eradication. METHODS Electronic databases, reviews, bibliographies, abstracts and conference proceedings were searched. Included trials had to be randomized or quasi-randomized and controlled, using bovine lactoferrin in the intervention group, treating Helicobacter-infected subjects and evaluating eradication of H. pylori as an outcome. RESULTS The search identified five eligible RCTs (of 169). Data were available for 682 subjects (bovine lactoferrin group-n = 316; control group-n = 366). The pooled odds ratio (five studies) for eradication by intention-to-treat analysis was 2.22 (95% CI 1.44-3.44; P = 0.0003) using the fixed effects model (FEM) and 2.24 (95% CI 1.15-4.35; P = 0.0003) using the random effects model (REM) (Cochran's Q = 6.83; P = 0.145). The pooled risk difference was 0.11 (95% CI 0.05-0.16; P = 0.0001) by FEM (Cochran's Q = 6.67; P = 0.154) and 0.10 (95% CI 0.04-0.17; P = 0.0023) by REM. There was no significant difference in incidence of adverse effects. CONCLUSION Bovine lactoferrin potentially improves H. pylori eradication rates without any impact on adverse effects, but available evidence is limited and further research is necessary to confirm the findings.