Academic Journal
Efficacy and Safety of Quadruple Therapy With Semisynthetic Tetracycline for Helicobacter pylori Eradication: A Meta-Analysis.
| Τίτλος: | Efficacy and Safety of Quadruple Therapy With Semisynthetic Tetracycline for Helicobacter pylori Eradication: A Meta-Analysis. |
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| Συγγραφείς: | Guo QQ; State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, National Clinical Research Center for Digestive Diseases, Department of Gastroenterology & Hepatology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China.; Postgraduate Department, Xi'an Medical University, Xi'an, China., Zhang J; State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, National Clinical Research Center for Digestive Diseases, Department of Gastroenterology & Hepatology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China.; Department of Gastroenterology, Pingdingshan Medical District, 989 Hospital of PLA Joint Logistics Support Force, Pingdingshan, China., Zhu XJ; State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, National Clinical Research Center for Digestive Diseases, Department of Gastroenterology & Hepatology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China., Li WY; State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, National Clinical Research Center for Digestive Diseases, Department of Gastroenterology & Hepatology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China., Zhao DY; State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, National Clinical Research Center for Digestive Diseases, Department of Gastroenterology & Hepatology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China., Liang MQ; State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, National Clinical Research Center for Digestive Diseases, Department of Gastroenterology & Hepatology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China.; Postgraduate Department, Yan'an Medical University, Yan'an, China., Yan R; State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, National Clinical Research Center for Digestive Diseases, Department of Gastroenterology & Hepatology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China.; Postgraduate Department, Shaanxi University of Chinese Medicine, Xianyang, China., Shi YQ; State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, National Clinical Research Center for Digestive Diseases, Department of Gastroenterology & Hepatology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China. |
| Πηγή: | Journal of gastroenterology and hepatology [J Gastroenterol Hepatol] 2026 May; Vol. 41 (5), pp. 1403-1414. Date of Electronic Publication: 2026 Mar 19. |
| Τύπος έκδοσης: | Journal Article; Meta-Analysis; Systematic Review |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Blackwell Scientific Publications Country of Publication: Australia NLM ID: 8607909 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1440-1746 (Electronic) Linking ISSN: 08159319 NLM ISO Abbreviation: J Gastroenterol Hepatol Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Melbourne ; Boston : Blackwell Scientific Publications, c1986- |
| Ιατρικοί όροι (MeSH): | Helicobacter Infections*/drug therapy , Helicobacter Infections*/microbiology , Tetracycline*/administration & dosage , Tetracycline*/adverse effects , Anti-Bacterial Agents*/administration & dosage , Anti-Bacterial Agents*/adverse effects , Helicobacter pylori*, Bismuth/administration & dosage ; Minocycline/administration & dosage ; Humans ; Drug Therapy, Combination ; Treatment Outcome ; Randomized Controlled Trials as Topic ; Retrospective Studies |
| Περίληψη: | Background: High antibiotic resistance and limited tetracycline accessibility severely restrict the clinical application of classic bismuth quadruple therapy (BQT), creating an urgent demand for alternative regimens. Methods: A systematic search was conducted in PubMed, Embase, Cochrane Library, and Web of Science up to June 3, 2025, for trials comparing Helicobacter pylori eradication rates and adverse events between semisynthetic tetracycline-containing quadruple therapies and non-semisynthetic tetracycline controls. Statistical analysis was performed using RevMan 5.4. Results: This meta-analysis included 11 randomized controlled trials (RCTs) and two retrospective studies (3667 participants). Semisynthetic tetracycline-containing regimens yielded significantly higher Hp eradication rates (per-protocol [PP] analysis: 91.8% vs. 85.6%; OR = 1.47, 95% CI: 1.08-2.00; p = 0.01) and fewer adverse events (32% vs. 39.2%; OR = 0.73, 95% CI: 0.56-0.94; p = 0.02). Minocycline-containing regimens were associated with a higher incidence of dizziness/headache (18.9% vs. 10.5%; OR = 2.22, 95% CI: 1.74-2.84; p < 0.00001). Subgroup PP analysis showed doxycycline-containing regimens outperformed controls (82.6% vs. 71.8%; OR = 1.56, 95% CI: 1.03-2.35; p = 0.04), and a 14-day course improved eradication rates (92.3% vs. 88.5%). Conclusions: Semisynthetic tetracycline-containing regimens exhibit favorable efficacy and safety for H. pylori eradication, representing promising alternatives to traditional tetracyclines in clinical practice. (© 2026 The Author(s). Journal of Gastroenterology and Hepatology published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.) |
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| Grant Information: | 2024TD-06 Shaanxi Health Scientific Research Innovation Team; 2025ZD0545301 Noncommunicable Chronic Diseases-National Science and Technology Major |
| Contributed Indexing: | Keywords: Helicobacter pylori; doxycycline; eradication; meta‐analysis; minocycline; quadruple therapy; semisynthetic tetracycline |
| Substance Nomenclature: | F8VB5M810T (Tetracycline) 0 (Anti-Bacterial Agents) U015TT5I8H (Bismuth) FYY3R43WGO (Minocycline) |
| Entry Date(s): | Date Created: 20260319 Date Completed: 20260711 Latest Revision: 20260813 |
| Update Code: | 20260813 |
| PubMed Central ID: | PMC13158637 |
| DOI: | 10.1111/jgh.70348 |
| PMID: | 41852181 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1440-1746 |
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| DOI: | 10.1111/jgh.70348 |