Pharmacological regimens for eradication of Helicobacter pylori: an overview of systematic reviews and network meta-analysis

Xin, Yiqiao; Manson, Jan; Govan, Lindsay; Harbour, Robin; Bennison, Jenny; Watson, Eleanor; Wu, Olivia

doi:10.1186/s12876-016-0491-7

Table 3 Characteristics of systematic reviews comparing triple therapy with different antibiotics (n = 8)

From: Pharmacological regimens for eradication of Helicobacter pylori: an overview of systematic reviews and network meta-analysis

Author, Year, country	Last search date	Disease	Countries of included RCTs^c	Intervention	Comparator	No. of studies in MA	No. of patients in MA	Eradication rates by ITT	Eradication rates odds ratio (95 % CI) by ITT	Quality assessment^b
Zhang et al. 2008 China [25]	May 2008	HP infection; naïve to treatment; PUD/NUD	China (8), Italy (3)	Levofloxacin-containing triple: levofloxacin+	Standard triple: clarithromycin+	11	1926	Not reported	1.56 (1.25–1.94)	0
Zhang et al. 2008 China [25]	May 2008	HP infection; naïve to treatment; PUD/NUD	China (8), Italy (3)	+same PPI(Ome/panto/esome) + another one antibiotic (furazolidone/amoxicillin/azithromycin/metronidazole/tinidazole)		11	1926	Not reported	1.56 (1.25–1.94)	0
Dong et al. 2009 China [33]	May 2009	HP infection; naïve to treatment	China (4), Italy (5), Korea, Russia, France, Croatia, US	Azithromycin-containing triple: azithromycin+ + one antibiotic (levofloxacin/amoxicillin/metronidazole)+	Azithromycin NOT-containing triple: + two antibiotics (amoxicillin/clarithromycin/metronidazole/tinidazole)+	14	1431	72.0 % vs. 69.8 %	1.17 (0.64–2.14)	+
Dong et al. 2009 China [33]	May 2009	HP infection; naïve to treatment	China (4), Italy (5), Korea, Russia, France, Croatia, US	+same PPI (ome/esome/lanso/panto)		14	1431	72.0 % vs. 69.8 %	1.17 (0.64–2.14)	+
Yuan et al. 2009 China [34]	Dec 2008	HP infection; naïve to treatment	Italy, Croatia, Turkey, China	Moxifloxacin-containing triple: moxifloxacin+	Clarithromycin-containing triple: clarithromycin+	4	772	84.1 % vs. 73.6 %	1.13 (1.01–1.27)^a	+
Yuan et al. 2009 China [34]	Dec 2008	HP infection; naïve to treatment	Italy, Croatia, Turkey, China	+ same PPI (esome/lanso/ome) + another same regimen (amoxicillin/tinidazole/metronidazole/bismuth-)		4	772	84.1 % vs. 73.6 %	1.13 (1.01–1.27)^a	+
Zhang et al. 2013 China [47]	March 2012	HP infection; PUD/NUD/others; either naive or with previous treatment failures	Korea (2), Croatia (2), China, Italy, Turkey	Moxifloxacin-containing triple OR Quadruple: moxifloxacin + amoxicillin/metronidazole/tinidazole +/− RBC+	Standard triple or quadruple: (+/−)Bismuth/RBC + metronidazole/tinidazole/clarithromycin/amoxicillin+	7	1263	79.0 % vs. 68.3 %	1.82 (1.17–2.81)	+
			Korea (2), Croatia (2), China, Italy, Turkey	+ same PPI (esome/ome/rabe/lanso)		7	1263	79.0 % vs. 68.3 %	1.82 (1.17–2.81)
			Croatia, Turkey, Italy	First-line	First-line	3	717	Not reported	1.80 (0.71–4.55)
				Moxifloxacin-containing triple OR Quadruple: moxifloxacin + amoxicillin/metronidazole/tinidazole (+/−) RBC+	Standard triple or quadruple: (+/−) Bismuth/RBC + metronidazole/tinidazole/clarithromycin/amoxicillin+
				+ same PPI (esome/lanso)
			Croatia, Korea (2), China	Second-line	Second-line	4	546	73.3 % vs. 60.2 %	1.78 (1.16–2.73)
				Moxifloxacin-containing triple: moxifloxacin + metronidazole/amoxicillin+	Standard triple or quadruple: (+/−) Bismuth + metronidazole/tinidazole/clarithromycin+
				+ same PPI (esome/ome/rabe)
			Croatia, Korea (2), Turkey, Italy, China	Moxifloxacin + amoxicillin (+/−) RBC+	Standard triple or quadruple: (+/−) Bismuth/RBC + metronidazole/tinidazole/clarithromycin/amoxicillin+	6	810	Not reported	1.50 (0.95–2.38)
			Croatia, Korea (2), Turkey, Italy, China	+ same PPI(esome/ome/rabe/lanso)		6	810	Not reported	1.50 (0.95–2.38)
			Croatia (2), Italy	Moxifloxacin + metronidazole/tinidazole+	Standard triple or quadruple: (+/−) Bismuth/RBC + metronidazole/tinidazole/clarithromycin/amoxicillin+	3	453	Not reported	3.00 (1.84–4.89)
			Croatia (2), Italy	+ same PPI (esome/ome/rabe/lanso)		3	453	Not reported	3.00 (1.84–4.89)
Ye et al. 2014 China [35]	August 2013	HP infection; naïve to treatment	Germany, Egypt, Taiwan (2), China (2), Spain (2), Italy (2)	Levofloxacin-containing triple: levofloxacin+	Standard triple: clarithromycin+	10	2676	81.5 % vs. 77.2 %	1.28 (0.88–1.85)	++
Ye et al. 2014 China [35]	August 2013	HP infection; naïve to treatment	Germany, Egypt, Taiwan (2), China (2), Spain (2), Italy (2)	+same PPI(Ome/lanso/esome) + another one antibiotic (amoxicillin/metronidazole)		10	2676	81.5 % vs. 77.2 %	1.28 (0.88–1.85)	++
Peedikayil et al. 2014 Saudi Arabia [36]	March 2013	HP infection; naïve to treatment	Egypt and Saudi Arabia, Taiwan (2), South Korea, China, Italy (2)	Levofloxacin-containing triple: levofloxacin+	Standard triple: clarithromycin+	7	1782	79.1 % vs. 81.4 %	0.97 (0.93–1.02)^a	+
Peedikayil et al. 2014 Saudi Arabia [36]	March 2013	HP infection; naïve to treatment		+same PPI(Ome/lanso/esome) + another one antibiotic (amoxicillin/+metronidazole/clarithromycin/azithromycin)		7	1782	79.1 % vs. 81.4 %	0.97 (0.93–1.02)^a	+
Xiao et al. 2014 China [37]	March 2013	HP infection; naïve to treatment, PUD/NUD/not reported	Italy (2), China (3), Spain (2), Egypt and Saudi Arabia, Korea	Levofloxacin-containing triple: levofloxacin+	Standard triple: clarithromycin+	9	2512	80.2 % vs. 77.4 %	1.03 (0.94–1.13)^a	++
Xiao et al. 2014 China [37]	March 2013	HP infection; naïve to treatment, PUD/NUD/not reported		+same PPI(Ome/lanso/esome) + another one antibiotic (amoxicillin/+metronidazole/clarithromycin/azithromycin)		9	2512	80.2 % vs. 77.4 %	1.03 (0.94–1.13)^a	++
Gou et al. 2014 China [26]	December 2013	HP infection; naïve to treatment	All from China	Levofloxacin-containing triple: levofloxacin+	Standard triple: clarithromycin+	21	2697	82.3 % vs.73.8 %	1.12 (1.08–1.16)^a	0
Gou et al. 2014 China [26]	December 2013	HP infection; naïve to treatment	All from China	No details reported		21	2697	82.3 % vs.73.8 %	1.12 (1.08–1.16)^a	0

HP H.pylori, PPI proton pump inhibitor, esome esomeprazole, lanso lansoprazole, ome omeprazole, panto pantoprazole, rabe rabeprazole, PUD peptic ulcer disease, NUD non-ulcer dyspepsia, MA meta-analysis, ITT intention to treat, CI confidence interval, RCT randomized controlled trials, RBC ranitidine bismuth citrate
^a Relative risk is reported here
^b Quality assessment: high quality (++): majority of criteria met, little or no risk of bias and results unlikely to be changed by further research. Acceptable (+): most criteria met, some flaws in the study with an associated risk of bias and conclusions may change in the light of further studies. Low quality (0): either most criteria not met or significant flaws relating to key aspects of study design, and conclusions likely to change in the light of further studies
^c Countries of included RCTs: the number in the bracket represents the number of trials from the same country if more than one trial exists

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