Helicobacter pylori (H. pylori) is a major risk factor for gastric cancer (GC) and multiple other chronic illnesses. Host genetic factors influence the susceptibility to H. pylori infection, as evidenced by elevated concordance in monozygotic twins and racial disparities independent of socioeconomic status. Leveraging meta-analyses and in silico functional annotation, we investigated host genetic susceptibility to H. pylori infection, and to examine how these variants may influence gastric cancer (GC) risk.
Methods
Meta-analyses were performed on 25 candidate genetic variants that had been investigated for the association with H. pylori infection in at least three studies, under five genetic models (allelic, dominant, recessive, homozygous, and heterozygous). Meta-analyses on genome-wide variants were conducted using the allelic model. The Bayesian False-Discovery Probability method and Venice criteria were used to assess genetic association credibility. The Genotype-Tissue Expression (GTEx) and eQTLGen databases were used for cis-expression quantitative trait locus (eQTL) analysis. Differential gene expression in H. pylori-positive (n = 61) vs. -negative (n = 17) samples, and GC (n = 414) vs. non-GC tissues (n = 210) was analyzed leveraging The Cancer Genome Atlas, GTEx, and in-house RNA-sequencing data.
Results
From a total of 103 studies for systematic review, meta-analyses based on 83 studies identified 47 variants across 18 loci associated with H. pylori susceptibility. These loci encompassed 29 cis-eQTLs affecting expression of 42 genes. Of them, seven genes at three loci—4p14 (TLR10, TLR6, KLHL5, TMEM156), 6p21.33 (HLA-DRB6, C4B), and 14q32.2 (WARS)—were consistently upregulated in H. pylori infection and GC, which may contribute to H. pylori infection-related GC development.
Conclusion
Host genetic predisposition alters the odds of H. pylori infection, demonstrating the importance of host-pathogen crosstalk in infection dynamics and subsequent gastric carcinogenesis.
{"title":"Host Genetic Variants Associated With Helicobacter pylori Infection: A Meta-Analysis Combined With Functional Annotation","authors":"Wen-Jing Zhao, Heng-Min Xu, Chao Zhang, Xiao-Wen Jiang, Kai-Feng Pan, Wen-Qing Li","doi":"10.1111/hel.70098","DOIUrl":"10.1111/hel.70098","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p><i>Helicobacter pylori</i> (<i>H. pylori</i>) is a major risk factor for gastric cancer (GC) and multiple other chronic illnesses. Host genetic factors influence the susceptibility to <i>H. pylori</i> infection, as evidenced by elevated concordance in monozygotic twins and racial disparities independent of socioeconomic status. Leveraging meta-analyses and <i>in silico</i> functional annotation, we investigated host genetic susceptibility to <i>H. pylori</i> infection, and to examine how these variants may influence gastric cancer (GC) risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Meta-analyses were performed on 25 candidate genetic variants that had been investigated for the association with <i>H. pylori</i> infection in at least three studies, under five genetic models (allelic, dominant, recessive, homozygous, and heterozygous). Meta-analyses on genome-wide variants were conducted using the allelic model. The Bayesian False-Discovery Probability method and Venice criteria were used to assess genetic association credibility. The Genotype-Tissue Expression (GTEx) and eQTLGen databases were used for cis-expression quantitative trait locus (eQTL) analysis. Differential gene expression in <i>H. pylori</i>-positive (<i>n</i> = 61) vs. -negative (<i>n</i> = 17) samples, and GC (<i>n</i> = 414) vs. non-GC tissues (<i>n</i> = 210) was analyzed leveraging The Cancer Genome Atlas, GTEx, and in-house RNA-sequencing data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From a total of 103 studies for systematic review, meta-analyses based on 83 studies identified 47 variants across 18 loci associated with <i>H. pylori</i> susceptibility. These loci encompassed 29 cis-eQTLs affecting expression of 42 genes. Of them, seven genes at three loci—4p14 (<i>TLR10</i>, <i>TLR6</i>, <i>KLHL5</i>, <i>TMEM156</i>), 6p21.33 (<i>HLA-DRB6</i>, <i>C4B</i>), and 14q32.2 (<i>WARS</i>)—were consistently upregulated in <i>H. pylori</i> infection and GC, which may contribute to <i>H. pylori</i> infection-related GC development.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Host genetic predisposition alters the odds of <i>H. pylori</i> infection, demonstrating the importance of host-pathogen crosstalk in infection dynamics and subsequent gastric carcinogenesis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145849829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Miao Duan, Teng Teng, Qingzhou Kong, Yueyue Li, Xiuli Zuo
Background and Aims
The rising antibiotic resistance of Helicobacter pylori has led to variability in efficacy of bismuth-containing quadruple therapy (BcQT). This network meta-analysis (NMA) aimed to compare the efficacy of antibiotic combinations in first-line BcQT.
Methods
Following PRISMA guidelines with PROSPERO registration (CRD420251005598), we systematically searched PubMed, Embase, Web of Science, and Cochrane Library for randomized controlled trials (RCTs) published between January 1, 2005 and March 21, 2025. Eligible studies were selected by predefined criteria. Dichotomous outcomes included H. pylori eradication rates, adverse events, and compliance, analyzed as odds ratios (ORs) with 95% credible intervals (95% CrI) or 95% confidence intervals (95% CI). Treatments were ranked via surface under the cumulative ranking curve (SUCRA).
Results
This NMA included 25 RCTs (n = 7624) evaluating 19 regimens. Amoxicillin-metronidazole ranked highest globally (SUCRA = 0.866) in intention-to-treat analyses and in Asia (SUCRA = 0.851), particularly during 2016–2025 (SUCRA = 0.859; OR = 3.43, 95% CrI 1.17–10.05). Metronidazole-tetracycline was optimal in Europe (SUCRA = 0.969; OR = 2.13, 95% CrI 1.15–3.95), amoxicillin-minocycline in China (SUCRA = 0.733). Notably, regimens including levofloxacin or clarithromycin significantly decreased eradication rates in China (OR = 1.32; 95% CI 1.04–1.66; p = 0.02). Amoxicillin-furazolidone had the poorest adverse events (SUCRA = 0.792). Compliance was highest with amoxicillin-moxifloxacin (SUCRA = 0.878).
Conclusion
Superior eradication was achieved with BcQT by utilizing dual low-resistance antibiotics per local surveillance data. Amoxicillin-metronidazole may represent optimal regimens for primary H. pylori eradication efficacy in BcQT. Substantial efficacy variation in antibiotic combinations necessitates tailored treatment guided by antibiotic resistance surveillance.
背景与目的：幽门螺杆菌耐药性的上升导致含铋四联疗法（BcQT）疗效的变化。本网络荟萃分析（NMA）旨在比较抗生素联合治疗一线BcQT的疗效。方法：遵循PRISMA指南并注册（CRD420251005598），系统检索PubMed、Embase、Web of Science和Cochrane Library，检索2005年1月1日至2025年3月21日发表的随机对照试验（RCTs）。根据预先确定的标准选择符合条件的研究。二分类结果包括幽门螺杆菌根除率、不良事件和依从性，以95%可信区间（95% CrI）或95%可信区间（95% CI）的优势比（ORs）进行分析。在累积排序曲线（SUCRA）下，通过表面对处理进行排序。结果：该NMA纳入25项随机对照试验（n = 7624），评估19种方案。阿莫西林-甲硝唑在意向治疗分析中全球排名最高（SUCRA = 0.866），在亚洲排名最高（SUCRA = 0.851），特别是在2016-2025年期间（SUCRA = 0.859; OR = 3.43, 95% CrI 1.17-10.05）。欧洲以甲硝唑四环素（SUCRA = 0.969; OR = 2.13, 95% CrI 1.15-3.95）、中国以阿莫西林-米诺环素（SUCRA = 0.733）为最佳。值得注意的是，包括左氧氟沙星或克拉霉素在内的方案显著降低了中国的根除率（or = 1.32; 95% CI 1.04-1.66; p = 0.02）。阿莫西林-呋喃唑酮不良事件发生率最低（SUCRA = 0.792）。阿莫西林-莫西沙星的依从性最高（SUCRA = 0.878）。结论：根据当地监测数据，采用双低耐药抗生素治疗BcQT取得了较好的根除效果。阿莫西林-甲硝唑可能是BcQT原发性幽门螺杆菌根除疗效的最佳方案。抗生素组合的巨大疗效差异需要在抗生素耐药性监测的指导下进行量身定制的治疗。
{"title":"Antibiotic Combinations in Bismuth-Containing Quadruple Therapy for Helicobacter pylori Eradication: A Systematic Review and Network Meta-Analysis","authors":"Miao Duan, Teng Teng, Qingzhou Kong, Yueyue Li, Xiuli Zuo","doi":"10.1111/hel.70101","DOIUrl":"10.1111/hel.70101","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>The rising antibiotic resistance of <i>Helicobacter pylori</i> has led to variability in efficacy of bismuth-containing quadruple therapy (BcQT). This network meta-analysis (NMA) aimed to compare the efficacy of antibiotic combinations in first-line BcQT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Following PRISMA guidelines with PROSPERO registration (CRD420251005598), we systematically searched PubMed, Embase, Web of Science, and Cochrane Library for randomized controlled trials (RCTs) published between January 1, 2005 and March 21, 2025. Eligible studies were selected by predefined criteria. Dichotomous outcomes included <i>H. pylori</i> eradication rates, adverse events, and compliance, analyzed as odds ratios (ORs) with 95% credible intervals (95% CrI) or 95% confidence intervals (95% CI). Treatments were ranked via surface under the cumulative ranking curve (SUCRA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This NMA included 25 RCTs (<i>n</i> = 7624) evaluating 19 regimens. Amoxicillin-metronidazole ranked highest globally (SUCRA = 0.866) in intention-to-treat analyses and in Asia (SUCRA = 0.851), particularly during 2016–2025 (SUCRA = 0.859; OR = 3.43, 95% CrI 1.17–10.05). Metronidazole-tetracycline was optimal in Europe (SUCRA = 0.969; OR = 2.13, 95% CrI 1.15–3.95), amoxicillin-minocycline in China (SUCRA = 0.733). Notably, regimens including levofloxacin or clarithromycin significantly decreased eradication rates in China (OR = 1.32; 95% CI 1.04–1.66; <i>p</i> = 0.02). Amoxicillin-furazolidone had the poorest adverse events (SUCRA = 0.792). Compliance was highest with amoxicillin-moxifloxacin (SUCRA = 0.878).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Superior eradication was achieved with BcQT by utilizing dual low-resistance antibiotics per local surveillance data. Amoxicillin-metronidazole may represent optimal regimens for primary <i>H. pylori</i> eradication efficacy in BcQT. Substantial efficacy variation in antibiotic combinations necessitates tailored treatment guided by antibiotic resistance surveillance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145843748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Baixiang He, Xiaochi Ma, Mingyue Liu, Xiangyun Zou, Jean Carlo Xin Peng Ye, Ran Zhang, Zhihong Li
Introduction
A central controversy in autoimmune gastritis (AIG) concerns the true incidence of gastric cancer (GC) and gastric neuroendocrine tumors (gNETs). Reported risks vary widely, potentially influenced by Helicobacter pylori (HP) status, AIG subtypes, and age–factors not addressed in prior meta-analyses. This study aimed to determine the pooled incidence of GC and gNETs in AIG and to conduct a comprehensive stratified evaluation.
Methods
We searched PubMed, Embase, and Cochrane Library through May 2025 for observational studies reporting incident GC or gNETs in AIG. Subgroup analyses, sensitivity analyses, and meta-regression were conducted.
Results
Twenty-three studies were included: 19 hospital-based cohorts (n = 4309) and 4 registries (n = 36,015). The pooled incidence of GC was 0.12/100 person-years (PY; 95% CI, 0.06–0.17; I2 = 45.7%) and of gNETs 1.09/100 PY (95% CI, 0.61–1.58; I2 = 81.3%). By subtype, GC incidence was 0.29/100 PY in pernicious anemia (PA), 0.12 in histopathology-defined AIG, and 0.09 in parietal cell antibody (PCA)-positive patients; gNETs were highest in the hypergastrinemia subgroup (1.74/100 PY). By HP status, GC incidence was 0.12/100 PY in HP-naïve and 0.07 in HP-exposed patients. Age-stratified analyses showed a consistent upward trend in patients ≥ 60 years for both GC (0.27 vs. 0.10/100 PY) and gNETs (1.48 vs. 0.87/100 PY).
Conclusion
This study underscores the neoplastic risk associated with AIG. GC incidence is highest in PA and lower in PCA-positive patients, likely reflecting different AIG stages. HP-naïve status does not confer protection, and long-term GC risk persists. Age is a key modifier, providing a useful reference for risk stratification and individualized surveillance.
{"title":"Incidence of Gastric Cancer and Neuroendocrine Tumors in Autoimmune Gastritis: A Systematic Review and Meta-Analysis of Follow-Up Studies","authors":"Baixiang He, Xiaochi Ma, Mingyue Liu, Xiangyun Zou, Jean Carlo Xin Peng Ye, Ran Zhang, Zhihong Li","doi":"10.1111/hel.70096","DOIUrl":"10.1111/hel.70096","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>A central controversy in autoimmune gastritis (AIG) concerns the true incidence of gastric cancer (GC) and gastric neuroendocrine tumors (gNETs). Reported risks vary widely, potentially influenced by <i>Helicobacter pylori</i> (HP) status, AIG subtypes, and age–factors not addressed in prior meta-analyses. This study aimed to determine the pooled incidence of GC and gNETs in AIG and to conduct a comprehensive stratified evaluation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched PubMed, Embase, and Cochrane Library through May 2025 for observational studies reporting incident GC or gNETs in AIG. Subgroup analyses, sensitivity analyses, and meta-regression were conducted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-three studies were included: 19 hospital-based cohorts (<i>n</i> = 4309) and 4 registries (<i>n</i> = 36,015). The pooled incidence of GC was 0.12/100 person-years (PY; 95% CI, 0.06–0.17; <i>I</i><sup>2</sup> = 45.7%) and of gNETs 1.09/100 PY (95% CI, 0.61–1.58; <i>I</i><sup>2</sup> = 81.3%). By subtype, GC incidence was 0.29/100 PY in pernicious anemia (PA), 0.12 in histopathology-defined AIG, and 0.09 in parietal cell antibody (PCA)-positive patients; gNETs were highest in the hypergastrinemia subgroup (1.74/100 PY). By HP status, GC incidence was 0.12/100 PY in HP-naïve and 0.07 in HP-exposed patients. Age-stratified analyses showed a consistent upward trend in patients ≥ 60 years for both GC (0.27 vs. 0.10/100 PY) and gNETs (1.48 vs. 0.87/100 PY).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study underscores the neoplastic risk associated with AIG. GC incidence is highest in PA and lower in PCA-positive patients, likely reflecting different AIG stages. HP-naïve status does not confer protection, and long-term GC risk persists. Age is a key modifier, providing a useful reference for risk stratification and individualized surveillance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>PROSPERO database (CRD420251047873)</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145762586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Min J. Kim, Isiah Gonzalez, Nia M. Choi, David Y. Graham, Hashem B. El-Serag, Mimi C. Tan
Background
Helicobacter pylori infections are mostly treated empirically (without antibiotic susceptibility testing). Determining eradication rates of different treatment regimens can inform antibiotic resistance. Our aim was to examine eradication rates of empiric H. pylori treatments based on treatment regimen, race/ethnicity and previous treatment status in a multiethnic U.S. population.
Materials and Methods
This was a retrospective cross-sectional study of patients with a positive H. pylori test from 7/2021 to 4/2022 at Harris Health (Houston, Texas) who had received treatment and eradication testing within 1 year. We compared eradication rates based on treatment regimen, race/ethnicity, and prior treatment and examined other possible risk factors for treatment failure using logistic regression models.
Results
Among 1106 H. pylori-infected patients, 29.2% were male, 80.6% Hispanic, 10.7% black, 2.5% white, and 83.3% were non-U.S. born with a mean age of 50.8 years (standard deviation 12.6). Most patients (57.3%) received bismuth-tetracycline-metronidazole quadruple, 21.2% clarithromycin-metronidazole-amoxicillin quadruple, 15.6% clarithromycin-amoxicillin triple, and 3.9% received clarithromycin-metronidazole triple therapies. Eradication rates were highest for bismuth-tetracycline-metronidazole quadruple (83.8%), clarithromycin-metronidazole-amoxicillin quadruple (80.3%), and clarithromycin-amoxicillin triple therapies (79.2%). In 186 (16.8%) previously treated patients, all empiric regimens achieved < 80% eradication rates. Clarithromycin-amoxicillin triple had high eradication rates (92.9%) in black patients and bismuth quadruple therapy in Asians (95.8%). Compared to bismuth quadruple therapy, clarithromycin-metronidazole triple (adjusted odds ratio [adjOR] 0.31, 95% confidence interval [CI] 0.13–0.73) and levofloxacin-amoxicillin triple (adjOR 0.20, 95% CI 0.05–0.89) regimens were associated with treatment failure, whereas clarithromycin-amoxicillin quadruple and triple therapies were not.
Conclusions
Empiric bismuth quadruple therapy had the highest eradication rate while metronidazole and levofloxacin triple therapies had the lowest. Eradication rates may thus serve as a surrogate clinical endpoint when choosing empiric therapies.
背景：幽门螺杆菌感染大多是经验性治疗（没有抗生素药敏试验）。确定不同治疗方案的根除率可以为抗生素耐药性提供信息。我们的目的是根据治疗方案、种族/民族和美国多种族人群以前的治疗状况，检查幽门螺杆菌治疗的根除率。材料和方法：这是一项回顾性横断面研究，研究对象是Harris Health （Houston, Texas）在2021年7月至2022年4月期间幽门螺杆菌检测呈阳性的患者，这些患者在一年内接受了治疗和根除检测。我们比较了基于治疗方案、种族/民族和既往治疗的根除率，并使用逻辑回归模型检查了治疗失败的其他可能危险因素。结果：1106例幽门螺杆菌感染患者中，男性占29.2%，西班牙裔占80.6%，黑人占10.7%，白人占2.5%，非美国人占83.3%。平均出生年龄50.8岁（标准差12.6）。接受铋-四环素-甲硝唑四联治疗的患者占57.3%，接受克拉霉素-甲硝唑-阿莫西林四联治疗的患者占21.2%，接受克拉霉素-阿莫西林三联治疗的患者占15.6%，接受克拉霉素-甲硝唑三联治疗的患者占3.9%。铋-四环素-甲硝唑四联疗法根除率最高（83.8%），克拉霉素-甲硝唑-阿莫西林四联疗法根除率最高（80.3%），克拉霉素-阿莫西林三联疗法根除率最高（79.2%）。结论：经验铋四联疗法根除率最高，甲硝唑和左氧氟沙星三联疗法根除率最低。因此，在选择经验性疗法时，根除率可以作为替代临床终点。
{"title":"Eradication Rates of Empiric Helicobacter pylori Treatment Regimens by Race/Ethnicity in a Predominantly Immigrant U.S. Population","authors":"Min J. Kim, Isiah Gonzalez, Nia M. Choi, David Y. Graham, Hashem B. El-Serag, Mimi C. Tan","doi":"10.1111/hel.70095","DOIUrl":"10.1111/hel.70095","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p><i>Helicobacter pylori</i> infections are mostly treated empirically (without antibiotic susceptibility testing). Determining eradication rates of different treatment regimens can inform antibiotic resistance. Our aim was to examine eradication rates of empiric <i>H. pylori</i> treatments based on treatment regimen, race/ethnicity and previous treatment status in a multiethnic U.S. population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This was a retrospective cross-sectional study of patients with a positive <i>H. pylori</i> test from 7/2021 to 4/2022 at Harris Health (Houston, Texas) who had received treatment and eradication testing within 1 year. We compared eradication rates based on treatment regimen, race/ethnicity, and prior treatment and examined other possible risk factors for treatment failure using logistic regression models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 1106 <i>H. pylori</i>-infected patients, 29.2% were male, 80.6% Hispanic, 10.7% black, 2.5% white, and 83.3% were non-U.S. born with a mean age of 50.8 years (standard deviation 12.6). Most patients (57.3%) received bismuth-tetracycline-metronidazole quadruple, 21.2% clarithromycin-metronidazole-amoxicillin quadruple, 15.6% clarithromycin-amoxicillin triple, and 3.9% received clarithromycin-metronidazole triple therapies. Eradication rates were highest for bismuth-tetracycline-metronidazole quadruple (83.8%), clarithromycin-metronidazole-amoxicillin quadruple (80.3%), and clarithromycin-amoxicillin triple therapies (79.2%). In 186 (16.8%) previously treated patients, all empiric regimens achieved < 80% eradication rates. Clarithromycin-amoxicillin triple had high eradication rates (92.9%) in black patients and bismuth quadruple therapy in Asians (95.8%). Compared to bismuth quadruple therapy, clarithromycin-metronidazole triple (adjusted odds ratio [adjOR] 0.31, 95% confidence interval [CI] 0.13–0.73) and levofloxacin-amoxicillin triple (adjOR 0.20, 95% CI 0.05–0.89) regimens were associated with treatment failure, whereas clarithromycin-amoxicillin quadruple and triple therapies were not.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Empiric bismuth quadruple therapy had the highest eradication rate while metronidazole and levofloxacin triple therapies had the lowest. Eradication rates may thus serve as a surrogate clinical endpoint when choosing empiric therapies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12686601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145708074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Harindra Jayasekara, Julie K. Bassett, Howard Ho-Fung Tang, Yang Peng, Helen Tsimiklis, Robert L. O'Reilly, Brigid M. Lynch, Robert J. MacInnis, Graham G. Giles, Melissa C. Southey, Roger L. Milne, M. Constanza Camargo
Background
Autoimmune gastritis poses a risk for stomach cancer. However, its role relative to Helicobacter pylori-associated gastritis is uncertain. We assessed whether the associations between anti-parietal cell antibody (APCA) seropositivity and the risk of stomach cancer and its anatomical subtypes were modified by H. pylori infection.
Materials and Methods
A total of 244 incident gastric adenocarcinoma cases were identified from the Melbourne Collaborative Cohort Study (N = 41,513) and matched with 448 cancer-free controls using incidence density sampling with age as the time scale, matching on sex, year of birth, and country of birth. IgG antibodies against parietal cells and H. pylori were analyzed using commercially available ELISA kits. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using conditional logistic regression.
Results
Seropositivity for APCA was 21% for controls and 24% for cases (28% cardia, 23% non-cardia), while seropositivity for H. pylori was 62% for controls and 76% for cases (55% cardia, 81% non-cardia). The following ORs were observed for total, cardia, and non-cardia cancers in relation to APCA seropositivity: 1.21 (95% CI: 0.84–1.76), 1.99 (0.84–4.73), and 1.09 (0.71–1.66), respectively. Stronger associations were observed for cardia cancer in H. pylori-seropositive individuals (ORs, 3.60 [95% CI: 1.07–12.12] vs. 0.93 [0.24–3.57] for H. pylori-seronegative individuals; pinteraction = 0.15) and for non-cardia cancer in H. pylori-seronegative individuals (ORs, 2.56 [1.02–6.40] vs. 0.93 [0.56–1.54] for H. pylori-seropositive individuals; pinteraction = 0.06).
Conclusions
Our findings suggest a more complex association between autoimmune gastritis and the risk of stomach cancer. They also highlight the importance of early detection of autoimmune gastritis in stomach cancer prevention.
{"title":"Anti-Parietal Cell Antibodies Show Differential Associations With Stomach Cancer by Site and Helicobacter pylori Status","authors":"Harindra Jayasekara, Julie K. Bassett, Howard Ho-Fung Tang, Yang Peng, Helen Tsimiklis, Robert L. O'Reilly, Brigid M. Lynch, Robert J. MacInnis, Graham G. Giles, Melissa C. Southey, Roger L. Milne, M. Constanza Camargo","doi":"10.1111/hel.70093","DOIUrl":"10.1111/hel.70093","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Autoimmune gastritis poses a risk for stomach cancer. However, its role relative to <i>Helicobacter pylori</i>-associated gastritis is uncertain. We assessed whether the associations between anti-parietal cell antibody (APCA) seropositivity and the risk of stomach cancer and its anatomical subtypes were modified by <i>H. pylori</i> infection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A total of 244 incident gastric adenocarcinoma cases were identified from the Melbourne Collaborative Cohort Study (<i>N</i> = 41,513) and matched with 448 cancer-free controls using incidence density sampling with age as the time scale, matching on sex, year of birth, and country of birth. IgG antibodies against parietal cells and <i>H. pylori</i> were analyzed using commercially available ELISA kits. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using conditional logistic regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seropositivity for APCA was 21% for controls and 24% for cases (28% cardia, 23% non-cardia), while seropositivity for <i>H. pylori</i> was 62% for controls and 76% for cases (55% cardia, 81% non-cardia). The following ORs were observed for total, cardia, and non-cardia cancers in relation to APCA seropositivity: 1.21 (95% CI: 0.84–1.76), 1.99 (0.84–4.73), and 1.09 (0.71–1.66), respectively. Stronger associations were observed for cardia cancer in <i>H. pylori</i>-seropositive individuals (ORs, 3.60 [95% CI: 1.07–12.12] vs. 0.93 [0.24–3.57] for <i>H. pylori</i>-seronegative individuals; <i>p</i><sub>interaction</sub> = 0.15) and for non-cardia cancer in <i>H. pylori</i>-seronegative individuals (ORs, 2.56 [1.02–6.40] vs. 0.93 [0.56–1.54] for <i>H. pylori</i>-seropositive individuals; <i>p</i><sub>interaction</sub> = 0.06).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings suggest a more complex association between autoimmune gastritis and the risk of stomach cancer. They also highlight the importance of early detection of autoimmune gastritis in stomach cancer prevention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145677481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xiang Li, Yizhen Tao, Hangyu Li, Lisha Mai, Xindi He, Jingwen Yan, Xiao Yang
Background
Previous studies have established an association between Helicobacter pylori (H. pylori) infection and metabolic dysfunction-associated steatotic liver disease (MASLD). However, the specific effects of H. pylori eradication therapy on MASLD patients remain unclear. Therefore, this systematic review and meta-analysis aims to comprehensively evaluate the impact of H. pylori eradication therapy on the incidence and clinical course of MASLD.
Materials and Methods
Cohort studies and randomized controlled trials (RCTs) were systematically retrieved from PubMed, Embase, Cochrane Library, and Web of Science. Hazard ratios (HRs) from cohort studies and mean differences (MDs) from RCTs with their corresponding 95% confidence intervals (CIs) were calculated to assess the impact of H. pylori eradication therapy on MASLD risk and changes in laboratory parameters. Subgroup analyses were performed based on varying follow-up periods and intervention type. Sensitivity analyses were conducted to assess the robustness of the findings. Funnel plots were used to evaluate publication bias.
Results
Eight studies, including two cohort studies assessing the incidence risk and six RCTs analyzing laboratory parameters, were included, encompassing a total of 5320 participants. All eligible studies were subjected to meta-analysis of their respective outcomes. H. pylori eradication therapy was found to significantly lower the risk of developing MASLD (HR = 0.74, 95% CI: 0.65–0.85). In patients already diagnosed with MASLD, eradication therapy was associated with reductions in waist circumference (MD = −0.62, 95% CI: −1.20 to −0.03), aspartate aminotransferase (AST; MD = −2.12, 95% CI: −2.78 to −1.45), fasting blood glucose (FBG; MD = −0.33, 95% CI: −0.66 to −0.01), homeostasis model assessment of insulin resistance (HOMA-IR; MD = −0.21, 95% CI: −0.25 to −0.17).
Conclusions
The application of H. pylori eradication therapy correlates with a reduced risk of MASLD and favorable changes in anthropometric, hepatic, glycemic, and inflammatory outcomes, though these benefits may vary depending on the duration of follow-up and eradication methods.
{"title":"Effects of Helicobacter pylori Eradication on the Risk and Clinical Parameters of Metabolic Dysfunction-Associated Steatotic Liver Disease: A Systematic Review and Meta-Analysis","authors":"Xiang Li, Yizhen Tao, Hangyu Li, Lisha Mai, Xindi He, Jingwen Yan, Xiao Yang","doi":"10.1111/hel.70092","DOIUrl":"10.1111/hel.70092","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Previous studies have established an association between <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection and metabolic dysfunction-associated steatotic liver disease (MASLD). However, the specific effects of <i>H. pylori</i> eradication therapy on MASLD patients remain unclear. Therefore, this systematic review and meta-analysis aims to comprehensively evaluate the impact of <i>H. pylori</i> eradication therapy on the incidence and clinical course of MASLD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Cohort studies and randomized controlled trials (RCTs) were systematically retrieved from PubMed, Embase, Cochrane Library, and Web of Science. Hazard ratios (HRs) from cohort studies and mean differences (MDs) from RCTs with their corresponding 95% confidence intervals (CIs) were calculated to assess the impact of <i>H. pylori</i> eradication therapy on MASLD risk and changes in laboratory parameters. Subgroup analyses were performed based on varying follow-up periods and intervention type. Sensitivity analyses were conducted to assess the robustness of the findings. Funnel plots were used to evaluate publication bias.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eight studies, including two cohort studies assessing the incidence risk and six RCTs analyzing laboratory parameters, were included, encompassing a total of 5320 participants. All eligible studies were subjected to meta-analysis of their respective outcomes. <i>H. pylori</i> eradication therapy was found to significantly lower the risk of developing MASLD (HR = 0.74, 95% CI: 0.65–0.85). In patients already diagnosed with MASLD, eradication therapy was associated with reductions in waist circumference (MD = −0.62, 95% CI: −1.20 to −0.03), aspartate aminotransferase (AST; MD = −2.12, 95% CI: −2.78 to −1.45), fasting blood glucose (FBG; MD = −0.33, 95% CI: −0.66 to −0.01), homeostasis model assessment of insulin resistance (HOMA-IR; MD = −0.21, 95% CI: −0.25 to −0.17).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The application of <i>H. pylori</i> eradication therapy correlates with a reduced risk of MASLD and favorable changes in anthropometric, hepatic, glycemic, and inflammatory outcomes, though these benefits may vary depending on the duration of follow-up and eradication methods.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145648501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Than Than Aye, Nwe Ni, Tin Tin May, Chit Kyi, Aye Mya Mya Kyaw, Thein Myint, Zeyar Lwin, Win Phyu Phyu Myint, Thein Saw, Than Than Swe, Kyaw Hla, Tin Moe Wai, Swe Mon Mya, Mya Thet Nwe, Thida Soe, Sandar Win, Than Than Aye, Thet Mar Win, Myint Naychi Tun, Thiri Tin, Aye Min Soe, Aung Kyaw Thu, Lin Htet Oo, Nang Khin Phone Tint, Kyaw Ko Ko Aung, Khun Nyi Nyi, Than Htun Oo, Moe Myint Aung, Naing Linn, Phyu Sin Aye, Kyaw Lun Aung Hmu, Nyi Nyi Aung, Min Htun, Tin Ma Ma Win, Kay Thi Kyaing, Swe Swe Lin, Kyaw Si Thu, Ohnmar Nyunt Tin, Su Su Hlaing
Myanmar has a significant rate of Helicobacter pylori (H. pylori) infection among Southeast Asian countries. The complications of H. pylori infections are common in Myanmar, ranging from peptic ulcer bleeding to gastric cancer. Myanmar has an intermediate risk of gastric cancer. In view of increasing drug resistance particularly to triple therapy, a standard management guideline is needed in Myanmar for the effective management of H. pylori infection. This is the first consensus guideline in Myanmar for local clinical practice. The consensus group consisted of 39 gastroenterologists and clinicians from Myanmar GI & Liver Society (MGLS), who had discussions in integrated meetings and developed consensus statements with the Delphi method and focused on the grades of recommendations, levels of evidence, and rationales for the management of H. pylori infection in daily practice in Myanmar. Due to the limited availability of high-quality local evidence, these consensus recommendations were based upon the best available evidence from the world's literature and guidelines, with special attention given to evidence from Myanmar. This consensus followed the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). The consensus level was defined as ≥ 80% for agreement on each statement. Finally, the panel reached a consensus on 26 statements which focus on four areas: (1) whom to test, (2) how to test, (3) whom to treat, and (4) how to treat with post-treatment confirmation of H. pylori status. This consensus will guide the proper diagnosis and treatment of H. pylori infection. In order to prevent antibiotic resistance, H. pylori infected individuals must have successful eradication. Future studies require third-line regimens and the development of antibiotic sensitivity tests. This consensus will serve as a useful guide for clinicians in their day-to-day clinical work.
{"title":"Management of Helicobacter pylori Infection: Myanmar Consensus Report","authors":"Than Than Aye, Nwe Ni, Tin Tin May, Chit Kyi, Aye Mya Mya Kyaw, Thein Myint, Zeyar Lwin, Win Phyu Phyu Myint, Thein Saw, Than Than Swe, Kyaw Hla, Tin Moe Wai, Swe Mon Mya, Mya Thet Nwe, Thida Soe, Sandar Win, Than Than Aye, Thet Mar Win, Myint Naychi Tun, Thiri Tin, Aye Min Soe, Aung Kyaw Thu, Lin Htet Oo, Nang Khin Phone Tint, Kyaw Ko Ko Aung, Khun Nyi Nyi, Than Htun Oo, Moe Myint Aung, Naing Linn, Phyu Sin Aye, Kyaw Lun Aung Hmu, Nyi Nyi Aung, Min Htun, Tin Ma Ma Win, Kay Thi Kyaing, Swe Swe Lin, Kyaw Si Thu, Ohnmar Nyunt Tin, Su Su Hlaing","doi":"10.1111/hel.70090","DOIUrl":"10.1111/hel.70090","url":null,"abstract":"<div>\u0000 \u0000 <p>Myanmar has a significant rate of <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection among Southeast Asian countries. The complications of <i>H. pylori</i> infections are common in Myanmar, ranging from peptic ulcer bleeding to gastric cancer. Myanmar has an intermediate risk of gastric cancer. In view of increasing drug resistance particularly to triple therapy, a standard management guideline is needed in Myanmar for the effective management of <i>H. pylori</i> infection. This is the first consensus guideline in Myanmar for local clinical practice. The consensus group consisted of 39 gastroenterologists and clinicians from Myanmar GI & Liver Society (MGLS), who had discussions in integrated meetings and developed consensus statements with the Delphi method and focused on the grades of recommendations, levels of evidence, and rationales for the management of <i>H. pylori</i> infection in daily practice in Myanmar. Due to the limited availability of high-quality local evidence, these consensus recommendations were based upon the best available evidence from the world's literature and guidelines, with special attention given to evidence from Myanmar. This consensus followed the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). The consensus level was defined as ≥ 80% for agreement on each statement. Finally, the panel reached a consensus on 26 statements which focus on four areas: (1) whom to test, (2) how to test, (3) whom to treat, and (4) how to treat with post-treatment confirmation of <i>H. pylori</i> status. This consensus will guide the proper diagnosis and treatment of <i>H. pylori</i> infection. In order to prevent antibiotic resistance, <i>H. pylori</i> infected individuals must have successful eradication. Future studies require third-line regimens and the development of antibiotic sensitivity tests. This consensus will serve as a useful guide for clinicians in their day-to-day clinical work.</p>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145512597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Helicobacter pylori (H. pylori) infection is a significant risk factor for gastric cancer. The effective implementation of strategies to mitigate gastric cancer requires widespread dissemination of information regarding H. pylori, diagnostic methods, and preventive measures. Despite the high incidence of gastric cancer, efforts to disseminate this information are lacking in Japan. Therefore, our survey aimed to evaluate H. pylori and gastric cancer awareness in Japan and identify factors associated with H. pylori knowledge, focusing on health literacy.
Materials and Methods
This nationwide cross-sectional survey was conducted online. We developed a questionnaire on H. pylori awareness and knowledge across four domains: infection risk, H. pylori-related diseases, testing and treatment, and gastric cancer-related problems. In addition, we evaluated health literacy using an established health literacy scale. Multivariable regression analysis was conducted using the H. pylori knowledge score as the dependent variable.
Results
Over half of the 3095 respondents were aware of H. pylori infection (56.4%). The overall correct response rate for the H. pylori knowledge questions was 45.7%, with varying performances across the knowledge domains: infection risk (57.3%), H. pylori-related diseases (50.9%), testing and treatment (37.5%), and gastric cancer (44.4%). The regression models identified the following factors as associated with a higher H. pylori knowledge: older age, higher health literacy scores, previous H. pylori testing, and healthcare professional status. Among participants without prior H. pylori testing, higher H. pylori knowledge scores were associated with a greater willingness to undergo H. pylori screening.
Conclusions
To our knowledge, this is the first nationwide assessment of H. pylori infection and gastric cancer awareness in Japan. Health literacy and previous H. pylori screening were significantly associated with H. pylori knowledge. The development of educational strategies for these factors may be desirable for gastric cancer prevention.
{"title":"Survey on Awareness of Helicobacter pylori and Gastric Cancer in the Japanese Population Using an Internet Survey","authors":"Chihiro Matsumoto, Hiroaki Saito, Yoshitaka Nishikawa, Yoshika Saito, Taiga Uchiyama, Toshihiko Kakiuchi, Yuichiro Eguchi, Yasuhiro Mizuno, Masaharu Tsubokura","doi":"10.1111/hel.70089","DOIUrl":"10.1111/hel.70089","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p><i>Helicobacter pylori</i> (<i>H. pylori</i>) infection is a significant risk factor for gastric cancer. The effective implementation of strategies to mitigate gastric cancer requires widespread dissemination of information regarding <i>H. pylori</i>, diagnostic methods, and preventive measures. Despite the high incidence of gastric cancer, efforts to disseminate this information are lacking in Japan. Therefore, our survey aimed to evaluate <i>H. pylori</i> and gastric cancer awareness in Japan and identify factors associated with <i>H. pylori</i> knowledge, focusing on health literacy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This nationwide cross-sectional survey was conducted online. We developed a questionnaire on <i>H. pylori</i> awareness and knowledge across four domains: infection risk, <i>H. pylori</i>-related diseases, testing and treatment, and gastric cancer-related problems. In addition, we evaluated health literacy using an established health literacy scale. Multivariable regression analysis was conducted using the <i>H. pylori</i> knowledge score as the dependent variable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Over half of the 3095 respondents were aware of <i>H. pylori</i> infection (56.4%). The overall correct response rate for the <i>H. pylori</i> knowledge questions was 45.7%, with varying performances across the knowledge domains: infection risk (57.3%), <i>H. pylori</i>-related diseases (50.9%), testing and treatment (37.5%), and gastric cancer (44.4%). The regression models identified the following factors as associated with a higher <i>H. pylori</i> knowledge: older age, higher health literacy scores, previous <i>H. pylori</i> testing, and healthcare professional status. Among participants without prior <i>H. pylori</i> testing, higher <i>H. pylori</i> knowledge scores were associated with a greater willingness to undergo <i>H. pylori</i> screening.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>To our knowledge, this is the first nationwide assessment of <i>H. pylori</i> infection and gastric cancer awareness in Japan. Health literacy and previous <i>H. pylori</i> screening were significantly associated with <i>H. pylori</i> knowledge. The development of educational strategies for these factors may be desirable for gastric cancer prevention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12605804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145495382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Qiang Han, Ming Zu, Shiyu Du, Yinyan Guo, Yuanmin Zhu, Yali Wang, Xiuqing Liu, Hongwei Guo, Yanli Cheng, Shigang Ding
<div> <section> <h3> Background</h3> <p>Current <i>Helicobacter pylori (H. pylori)</i> eradication regimens—standard triple, bismuth-containing quadruple, and non-bismuth quadruple therapies—still face issues such as adverse effects and poor compliance. High-dose dual therapy, with its simplicity, lower pill burden, and comparable efficacy, has recently gained attention. However, existing studies are largely single-center with small sample sizes and lack sufficient evidence-based support. This study aims to further evaluate the efficacy and safety of ilaprazole-based dual and quadruple therapies for <i>H. pylori</i> eradication.</p> </section> <section> <h3> Methods</h3> <p>This was a prospective, multicenter, randomized controlled, non-inferiority clinical trial conducted at five hospitals from January to November 2023. A total of 480 patients were randomly assigned to one of three treatment groups for 14 days: Group A (ilaprazole 5 mg, amoxicillin 1 g, clarithromycin 500 mg, and bismuth potassium citrate 220 mg, all administered twice daily), Group B (ilaprazole 5 mg twice daily and amoxicillin 1 g three times daily), and Group C (ilaprazole 10 mg twice daily and amoxicillin 1 g three times daily). The eradication rates, adverse events, and patient compliance were recorded.</p> </section> <section> <h3> Results</h3> <p>The eradication rates of <i>H. pylori</i> in Groups A, B, and C were 76.9%, 88.1%, and 88.7% (<i>p</i> = 0.004) by intention-to-treat analysis, respectively, and 78.3%, 90.4%, and 91.0% (<i>p</i> = 0.001) using modified intention-to-treat analysis, and 81.8%, 92.1%, 92.2% (<i>p</i> = 0.005) by per-protocol analysis. The adverse event rates were 28.0%, 10.2%, 10.8% in Groups A, B, and C, respectively (<i>p <</i> 0.001), while patient compliance rates were 91.1%, 98.1%, 98.7%, respectively (<i>p =</i> 0.001). Sex, smoking history, alcohol intake, and sharing tableware or cups did not affect the efficacy of the three treatment regimens.</p> </section> <section> <h3> Conclusions</h3> <p>The standard- or high-dose dual therapy with ilaprazole demonstrated superior efficacy, safety, and patient compliance compared to quadruple therapy. No significant differences were observed between these dual therapies, which are expected to become promising alternatives for the primary treatment of <i>H. pylori</i> infection.</p> </section> <section> <h3> Trial Registration</h3> <p>Chinese Clinical Trial Registry: ChiCTR2400086862</p>
{"title":"Different Doses of Ilaprazole for Dual Therapy Versus Bismuth-Quadruple Therapy for Helicobacter pylori Infection: A Three-Arm, Randomized Clinical Trial","authors":"Qiang Han, Ming Zu, Shiyu Du, Yinyan Guo, Yuanmin Zhu, Yali Wang, Xiuqing Liu, Hongwei Guo, Yanli Cheng, Shigang Ding","doi":"10.1111/hel.70086","DOIUrl":"10.1111/hel.70086","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Current <i>Helicobacter pylori (H. pylori)</i> eradication regimens—standard triple, bismuth-containing quadruple, and non-bismuth quadruple therapies—still face issues such as adverse effects and poor compliance. High-dose dual therapy, with its simplicity, lower pill burden, and comparable efficacy, has recently gained attention. However, existing studies are largely single-center with small sample sizes and lack sufficient evidence-based support. This study aims to further evaluate the efficacy and safety of ilaprazole-based dual and quadruple therapies for <i>H. pylori</i> eradication.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a prospective, multicenter, randomized controlled, non-inferiority clinical trial conducted at five hospitals from January to November 2023. A total of 480 patients were randomly assigned to one of three treatment groups for 14 days: Group A (ilaprazole 5 mg, amoxicillin 1 g, clarithromycin 500 mg, and bismuth potassium citrate 220 mg, all administered twice daily), Group B (ilaprazole 5 mg twice daily and amoxicillin 1 g three times daily), and Group C (ilaprazole 10 mg twice daily and amoxicillin 1 g three times daily). The eradication rates, adverse events, and patient compliance were recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The eradication rates of <i>H. pylori</i> in Groups A, B, and C were 76.9%, 88.1%, and 88.7% (<i>p</i> = 0.004) by intention-to-treat analysis, respectively, and 78.3%, 90.4%, and 91.0% (<i>p</i> = 0.001) using modified intention-to-treat analysis, and 81.8%, 92.1%, 92.2% (<i>p</i> = 0.005) by per-protocol analysis. The adverse event rates were 28.0%, 10.2%, 10.8% in Groups A, B, and C, respectively (<i>p <</i> 0.001), while patient compliance rates were 91.1%, 98.1%, 98.7%, respectively (<i>p =</i> 0.001). Sex, smoking history, alcohol intake, and sharing tableware or cups did not affect the efficacy of the three treatment regimens.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The standard- or high-dose dual therapy with ilaprazole demonstrated superior efficacy, safety, and patient compliance compared to quadruple therapy. No significant differences were observed between these dual therapies, which are expected to become promising alternatives for the primary treatment of <i>H. pylori</i> infection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>Chinese Clinical Trial Registry: ChiCTR2400086862</p>\u0000 ","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12598915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145482007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
X. Guo, M. C. W. Spaander, and G. M. Fuhler, ‘Letter to the Editor: “Parietal Cell Antibody Levels Among Chronic Gastritis Patients in a Country With Low Helicobacter pylori Infection: Epidemiology, Histopathological Features, and H. pylori Infection,”’ Helicobacter 30 no. 3 (2025): e70053, doi: https://doi.org/10.1111/hel.70053.
The following funding statement was omitted from the published article:
This research was supported by ZonMw (11140012410004).
We apologize for this error.
郭晓明，M. C. W. Spaander， G. M. Fuhler，“致编辑信：幽门螺杆菌低感染率国家慢性胃炎患者的壁细胞抗体水平：流行病学、组织病理学特征和幽门螺杆菌感染”，《幽门螺杆菌》第30期。3 (2025): e70053, doi: https://doi.org/10.1111/hel.70053.The在已发表的文章中省略了以下资金说明：本研究得到了ZonMw（11140012410004）的支持。我们为这个错误道歉。
{"title":"Correction to “Letter to the Editor: ‘Parietal Cell Antibody Levels Among Chronic Gastritis Patients in a Country With Low Helicobacter pylori Infection: Epidemiology, Histopathological Features, and H. pylori Infection’”","authors":"","doi":"10.1111/hel.70088","DOIUrl":"https://doi.org/10.1111/hel.70088","url":null,"abstract":"<p>X. Guo, M. C. W. Spaander, and G. M. Fuhler, ‘Letter to the Editor: “Parietal Cell Antibody Levels Among Chronic Gastritis Patients in a Country With Low <i>Helicobacter pylori</i> Infection: Epidemiology, Histopathological Features, and <i>H. pylori</i> Infection,”’ <i>Helicobacter</i> 30 no. 3 (2025): e70053, doi: https://doi.org/10.1111/hel.70053.</p><p>The following funding statement was omitted from the published article:</p><p>This research was supported by ZonMw (11140012410004).</p><p>We apologize for this error.</p>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.70088","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145449977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号