Treatment of Helicobacter pylori in the Arab world: a systematic review
and network meta-analysis
Abstract
Purpose: We aimed to conduct an updated systematic review and network
meta-analysis (NMA) to estimate the efficacy of Helicobacter pylori (H.
pylori) treatment strategies in Arab countries. Methods: We
systematically searched PubMed, Scopus, Web of Science (WOS), EBSCO, and
EMBASE from inception to July 18, 2020, using boolean operators.
Retrieved articles were screened, and relevant data were extracted. We
used R programming software to analyze extracted data. Results:
Fifty-four articles (n= 7829 patients) were included in the NMA. Pooled
overall analysis demonstrated that adjuvant therapy (standard triple or
sequential therapy plus another adjuvant drug) was the best treatment
with higher odds of eradication rate [OR= 6.42, 95% CI (1.37: 30.05),
P-score= 0.21]. Moreover, Seqential therapy (SQT) and Quinolone based
therapy (QBT) were associated with higher eradication rate compared to
other regimens [OR= 4.83, 95% CI (1.49: 15.64), P-score= 0.30] and
[OR= 4.32, 95% CI (1.15: 16.16), P-score= 0.36], respectively. In
adults, the efficacy of QBT was higher than other stratigies in terms of
H. pylori eradication [OR= 2.00, 95% CI (1.09, 3.69), P score=
0.19]. In naïve population, QBT and SQT were associated with
substantial eradication rate [OR= 1.94, 95% CI (1.19: 3.16), P
score=0.19] and [OR= 1.66, 95% CI (1.10: 2.50), P score=0.33],
respectively. Conclusion: Our findings suggest that standard triple or
sequential therapy plus another adjuvant drug, QBT and SQT therapies
were the most effective regimens for eradicating H.pylori in Arab
countries.