loading page

Treatment of Helicobacter pylori in the Arab world: a systematic review and network meta-analysis
  • +16
  • Shimaa Afify,
  • Muhammad Abdel-Gawad,
  • Eshak Bahbah,
  • Mariam Zaghloul,
  • Ahmed Abu-Elfatth,
  • Ahmed Alzamzamy,
  • Gina Naguib,
  • Doaa Elwazzan,
  • Nermeen Abdeen,
  • Mina Tharwat,
  • Osama Elbahr,
  • Iliass Charif,
  • Galal Aboufarrag ,
  • Mohamed El badry,
  • Dalia Omran,
  • Sherief Abd-Elsalam,
  • Zainab Ali-Eldin,
  • Nahed Makhlouf,
  • Mohamed Alboraie
Shimaa Afify
National Hepatology and Tropical Medicine Research Institute
Author Profile
Muhammad Abdel-Gawad
Al-Azhar University - Assiut Branch
Author Profile
Eshak Bahbah
Al-Azhar University
Author Profile
Mariam Zaghloul
Kafrelsheikh University
Author Profile
Ahmed Abu-Elfatth
Assiut University
Author Profile
Ahmed Alzamzamy
Maadi Armed Forces Hospital
Author Profile
Gina Naguib
Ain Shams University
Author Profile
Doaa Elwazzan
Alexandria University
Author Profile
Nermeen Abdeen
Alexandria University
Author Profile
Mina Tharwat
Aswan University
Author Profile
Osama Elbahr
Menoufia University National Liver Institute
Author Profile
Iliass Charif
Al Farabi Hospital, Oujda
Author Profile
Galal Aboufarrag
Al-Azhar University
Author Profile
Mohamed El badry
Helwan University
Author Profile
Dalia Omran
Cairo University
Author Profile
Sherief Abd-Elsalam
Tanta University
Author Profile
Zainab Ali-Eldin
Ain Shams University
Author Profile
Nahed Makhlouf
Assiut University
Author Profile
Mohamed Alboraie
Author Profile

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.

Peer review status:UNDER REVIEW

11 May 2021Submitted to British Journal of Clinical Pharmacology
13 May 2021Assigned to Editor
13 May 2021Submission Checks Completed
24 May 2021Reviewer(s) Assigned
10 Jun 2021Review(s) Completed, Editorial Evaluation Pending