Guideline-based bismuth quadruple therapy for helicobacter pylori infection in China: A systematic review and network meta-analysis.

<h4>Background</h4>Currently, quadruple therapy is unanimously recommended as the current first-line treatment option for Helicobacter pylori (H. Pylori) eradication. However, the drug composition of quadruple therapy is very complex, and the efficacy and safety between them is not clear...

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Main Authors: Jiali Wei, Zehao Zheng, Xin Wang, Boyi Jia, Mingyao Sun, Jiayi Wang, Qin Wan, Mei Han, Yue Qiu
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0318937
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Summary:<h4>Background</h4>Currently, quadruple therapy is unanimously recommended as the current first-line treatment option for Helicobacter pylori (H. Pylori) eradication. However, the drug composition of quadruple therapy is very complex, and the efficacy and safety between them is not clear.<h4>Aims</h4>To compare the efficacy and safety of H. Pylori eradication regimens, which were recommended by the Fifth Consensus of China, by network meta-analysis.<h4>Methods</h4>Literature databases were used to retrieve clinical randomized controlled trials of H. Pylori eradication. Network meta-analysis was performed using BUGSnet and meta package of R software, using OR values as effect size, and SUCRA was used to rank the efficacy of interventions under each outcome.<h4>Results</h4>A total of 55 studies and 130 arms were included. The NMA analysis found that the top regimen in term of eradication rate outcome was: Rabeprazole +  Bismuth +  Furazolidone +  Tetracycline (SUCRA, 97.5). In terms of safety outcomes: Lansoprazole +  Bismuth +  Amoxycillin +  Clarithromycin (SUCRA, 91.97).<h4>Conclusions</h4>The bismuth quadruple therapies recommended by the guidelines for the treatment of H. Pylori have good performance in terms of four-week eradication rate and safety outcome indicators, and due to the different resistance of antibiotics in different regional populations, rational use of drugs should be combined with local conditions.
ISSN:1932-6203