Helicobacter pylori infection

BackgroundThe effective regimen is lacking in areas with high antibiotic resistance and tetracycline unavailable. Whether minocycline can replace tetracycline for Helicobacter pylori eradication is unknown. This meta‐analysis compared and summarized the efficacy and safety profiles of H. pylori quadruple regimens with and without minocycline.Materials and MethodsWe conducted a literature search for regimens including minocycline quadruple therapy for H. pylori eradication and adverse events (AEs). Controls were patients undergoing any other treatment without minocycline. Searches were performed up to July 20, 2023, using PubMed and the Cochrane library.ResultsA total of five randomized controlled clinical trials with 2004 patients were included in this meta‐analysis. The H. pylori eradication rate of minocycline quadruple therapy was similar with that of control therapy (83.8% vs. 80.6%, OR 1.25, 95% CI [0.99–1.57], I2 = 0%, p = 0.06) in ITT analysis. When treatment regimens with minocycline were compared only with treatment regimens with tetracycline, no significant difference was found in eradication rate:85.5% vs. 85.5%, OR 1.00, 95% CI 0.67–1.47, p = 1.00. But when treatment regimens with minocycline were compared with treatment regimens without tetracycline, the former was significantly superiority to the latter (82.7% vs. 77.2%; OR, 1.40, 95% CI 1.06–1.87, p = 0.02). The incidence of AEs in the quadruple therapy with minocycline group was similar with the control group (35.9% vs. 38.8%, OR 0.88, 95% CI [0.73–1.06], I2 = 13%, p = 0.17).ConclusionsWe demonstrated the H. pylori eradication effect of minocycline quadruple therapy, and it might be an optional therapy. The safety of regimens containing minocycline was relatively satisfactory.

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of minocycline quadruple therapy for Helicobacter pylori eradication: A meta‐analysis of RCTs

Gao,

Zhu,

Yin

et al. 2023

“…Chronic active gastritis, a hallmark of H. pylori infection, occurs in all those infected. 15 Among infected individuals, the majority remain asymptomatic throughout their life, approximately 10% will develop peptic ulcers and 1%-3% will progresses to gastric cancer. 16,17 Chronic inflammation of gastric mucosa by H. pylori infection are essential in the occurrence and development of gastric cancer.…”

Section: H Pylori Infec Ti On and G A S Tric Infl Ammationmentioning

confidence: 99%

Helicobacter pylori infection and inflammasomes

Zheng,

Xia,

et al. 2024

Helicobacter pylori (H. pylori) causes the most prevalent bacterial infection worldwide, and more than half of the world's population is infected with H. pylori. Classified as a group 1 carcinogen of gastric cancer, H. pylori infection causes the most common chronic gastritis, which is able to progress to chronic atrophic gastritis, dysplasia, and even gastric cancer. The inflammasomes are important cytosolic multiprotein complexes to coordinate the host defense against foreign microorganisms and control the inflammatory response. It is also well‐known that inflammasome plays an important role in the occurrence of H. pylori‐induced gastric inflammation. During infection and inflammation, the activation process of inflammasome is tightly regulated by host immune system. However, excessive activation of inflammasome is closely related to the production of excessive cytokines that cause the body injury and resulting in various inflammatory diseases. In this review, we elaborate the activation and assembly mechanisms of inflammasome, the structure of different inflammasome complexes, host factors in vivo and drugs in vitro that regulate inflammasome signaling during H. pylori infection, aiming to provide novel insights and strategies for identifying new therapeutic targets for the treatment of H. pylori‐associated gastric mucosal diseases.

“…1 H. pylori infection can cause chronic gastritis, which may progress to peptic ulcer, and even gastric cancer. 2 Eradication of H. pylori could reduce peptic ulcer recurrence and reduce the incidence of gastric adenocarcinoma by approximately 50%. 3 However, rising antimicrobial resistance rates have led to an overall decline in treatment success, and research into antibiotic usage and eradication options is still underway.…”

Section: Introductionmentioning

confidence: 99%

Low‐dose or high‐dose amoxicillin in vonoprazan‐based dual therapy for Helicobacter pylori eradication? A systematic review and meta‐analysis

Ju,

Kong,

et al. 2024

BackgroundThe amoxicillin dose used in dual therapy to eradicate Helicobacter pylori varies across studies and the optimal amoxicillin dose for vonoprazan‐based dual therapies remains unclear. We aimed to investigate the efficacy and safety of low‐ and high‐dose amoxicillin in vonoprazan–amoxicillin dual therapy.Materials and MethodsA comprehensive systematic review was conducted by searching databases from inception to October 2023. All trials that evaluated the effectiveness and safety of vonoprazan–amoxicillin dual therapy for eradicating H. pylori were included. Pooled eradication rate, incidence of adverse events, relative risks, and 95% confidence intervals are presented.ResultsEighteen studies with 12 low‐dose amoxicillin (VLA) and 13 high‐dose amoxicillin (VHA) arms were included. The pooled eradication rates were 82.4% and 86.8% for VLA therapy, and 86.0% and 90.9% for VHA therapy by the intention‐to‐treat and per‐protocol analyses, respectively. In the subgroup analysis stratified by duration, the eradication rates achieved in 7 days, 10 days, and 14 days treatments with VLA and VHA dual therapies were 80.8%, 84.2%, 83.1%, and 67.3%, 88.8%, 87.5%, respectively. In the four randomized controlled trials that directly compared VLA and VHA dual therapies, the efficacy was not statistically different in the intention‐to‐treat (76.9% vs 81.4%, p = 0.337) and per‐protocol (81.6% vs 84.0%, p = 0.166) analyses. Additionally, the incidence of adverse events (p = 0.965) and compliance (p = 0.994) were similar in both groups.ConclusionVLA therapy demonstrated comparable efficacy and safety to VHA therapy, along with regional differences. An appropriately extended treatment duration may be critical for therapeutic optimization of vonoprazan–amoxicillin treatment.