Network meta-analysis of the efficacy and safety of dual amoxicillin-based regimens for Helicobacter pylori eradication
- VernacularTitle:阿莫西林二联方案根除幽门螺杆菌疗效与安全性的网状Meta分析
- Author:
Ziwen SONG
1
;
Xinmiao YUAN
1
;
Liyuan LUO
1
;
Yufang HE
1
;
Lingshu YANG
1
;
Yixu HUANG
1
;
Jianpeng SHE
1
;
Peihan WEI
1
;
Sihan GUO
1
;
Fei DUAN
2
Author Information
1. Dept. of Spleen，Stomach and Hepatobiliary Disease，the First Affiliated Hospital of Henan University of CM，Zhengzhou 450099，China;The First Clinical Medical College，Henan University of Chinese Medicine，Zhengzhou 450003，China
2. Dept. of Spleen，Stomach and Hepatobiliary Disease，the First Affiliated Hospital of Henan University of CM，Zhengzhou 450099，China
- Publication Type:Journal Article
- Keywords:
amoxicillin;
Helicobacter pylori;
dual therapy;
proton pump inhibitor;
potassium-competitive acid blocker
- From:
China Pharmacy
2026;37(8):1074-1079
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To evaluate the efficacy and safety of amoxicillin combined with proton pump inhibitor （PPI） or potassium-competitive acid blocker （P-CAB） for Helicobacter pylori （Hp） eradication. METHODS Randomized controlled trial （RCTs） on amoxicillin combined with PPI or P-CAB for Hp eradication were retrieved from PubMed， Embase， the Cochrane Library， Web of Science， CNKI， Wanfang， and VIP data. The search time frame was from database inception to September 5， 2025. After literature screening， data extraction， and quality assessment， a network meta-analysis was performed using Stata 17.0 software. RESULTS A total of 12 RCTs involving 5 515 patients were included， encompassing 8 therapeutic regimens： PPI combined with high-dose amoxicillin for 14 days （TR1）， PPI combined with low-dose amoxicillin for 14 days （TR2）， P-CAB combined with high-dose amoxicillin for 7 days （TR3）， P-CAB combined with high-dose amoxicillin for 14 days （TR4）， P-CAB combined with high-dose amoxicillin for 10 days （TR5）， P-CAB combined with low-dose amoxicillin for 7 days （TR6）， P-CAB combined with low-dose amoxicillin for 14 days （TR7）， and P-CAB combined with low-dose amoxicillin for 10 days （TR8）. The network meta-analysis results showed that， in terms of intention-to-treat Hp eradication rates， the eradication rates of TR5 and TR4 were significantly higher than those of TR3， TR8， TR6 and TR1 （ P ＜0.05）. The surface under the cumulative ranking curve （SUCRA） values from highest to lowest were： TR4 （89.7%）＞TR5 （82.3%）＞TR7 （71.5%）＞ TR2 （48.6%）＞TR1 （43.9%）＞TR8 （28.7%）＞TR3 （22.7%）＞TR6 （12.6%）. Regarding safety， the incidence of adverse reactions in TR3 and TR5 was significantly lower than that in TR1 （ P ＜0.05）. The SUCRA values from highest to lowest were： TR1 （91.3%）＞TR4 （79.8%）＞TR5 （55.0%）＞TR7 （50.9%）＞TR8 （41.3%）＞TR2 （36.4%）＞TR3 （27.6%） ＞TR6 （17.7%）. CONCLUSIONS Although the regimen of P-CAB combined with high-dose amoxicillin for 14 days demonstrates the best efficacy， the combination of P-CAB with high-dose amoxicillin for 10 days exhibits a better balanced profile in terms of both efficacy and safety.
