Minocycline in the eradication of Helicobacter pylori infection: A systematic review and meta-analysis

doi:10.3748/wjg.v30.i17.2354

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World Journal of Gastroenterology

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Meta-Analysis

World J Gastroenterol. May 7, 2024; 30(17): 2354-2368
Published online May 7, 2024. doi: 10.3748/wjg.v30.i17.2354

Table 1 Characteristics of included studies

Ref.	Country	Study type	Patient type	Regimen	Sample size	Duration (d)	Eradication rate (ITT analysis)	Eradication rate (PP analysis)	Compliance	Adverse effects rate	Resistance rate
Murakami et al[26], 2006	Japan	RCT	1^st	R 20 mg bid + CLA 200 mg bid + AMX 750 mg bid	40	7	82.5% (33/40)	84.6% (33/39)
		RCT	1^st	R 20 mg bid + MIN 100 mg bid + AMX 750 mg bid	39	7	38.5% (15/39)	40.5% (15/37)
		Cohort study	2^nd	R 20 mg bid + MIN 100 mg bid + MTZ 250 mg bid	67	7	85.1% (57/67)
		Cohort study	2^nd	R 20 mg bid + MIN 100 mg bid + FAR 600 mg bid	21	7	9.5% (2/21)
Ierardi et al[28], 2014	Italy	RCT	≥ 2^nd	R 20 mg bid + RIF 150 mg bid + MIN 100 mg bid + B 120 mg tid	27	10	77.8% (21/27)	84.0% (21/25)
Ierardi et al[28], 2014	Italy	RCT	≥ 2^nd	R 20 mg bid + MIN 100 mg bid + TNZ 500 mg bid + B 120 mg tid	27	10	51.9% (14/27)	51.9% (14/27)
Zhang et al[29], 2015	China	RCT	≥ 2^nd	R 10 mg bid + MIN 100 mg bid + AMX 1000 mg bid + B 220 mg bid	63	10	84.1% (53/63)	88.3% (53/60)	95.2% (60/63)	23.8% (15/63)
Zhang et al[29], 2015	China	RCT	≥ 2^nd	Tailored therapy (triple treatment)	62	10	75.8% (47/62)	79.7% (47/59)	96.8% (60/62)	33.9% (21/62)
Song et al[11], 2016	China	Cohort study	1^st	R 10 mg bid + MIN 100 mg bid + AMX 1000 mg bid + B 220 mg bid	160	14	87.5% (140/160)	92.6% (137/148)	94.7% (213/225)	24.0% (54/225)	6.9% (4/58)
Song et al[11], 2016	China	Cohort study	2^nd	R 10 mg bid + MIN 100 mg bid +AMX 1000 mg bid + B 220 mg bid	70	14	82.9% (58/70)	89.1% (57/64)	23.8% (15/63)		8.7% (2/23)
Song et al[12], 2016	China	Cohort study	1^st	E 20 mg bid + MIN 100 mg bid + MTZ 400 mg qid + B 110 mg qid	152	14	85.5% (130/152)	92.6% (137/148)	91.3% (136/149)	35.6% (53/149)
Song et al[12], 2016	China	Cohort study	2^nd	E 20 mg bid + MIN 100 mg bid + MTZ 400 mg qid + B 110 mg qid	64	14	82.8% (53/64)	89.5% (51/57)	90.5% (57/63)	36.5% (23/63)
Zhou[30], 2017	China	RCT	≥ 2^nd	AMLZ 20 mg bid + MIN 100 mg bid + AMX 1000 mg bid	50	7	80.00% (40/50)
				AMLZ 20 mg bid + MIN 100mg bid + AMX 1000 mg bid	50	10	82.00% (41/50)
				AMLZ 20 mg bid + MIN 100 mg bid + AMX 1000 mg bid + B 220 mg bid	50	10	84.00% (42/50)
				AMLZ 20 mg bid + CLA 500 mg bid + AMX 1000 mg bid + B 220 mg bid	50	10	52.00% (26/50)
Zhang et al[31], 2017	China	Cohort study	≥ 2^nd	R 10 mg bid + MIN 100 mg bid + AMX 1000 mg bid + B 220 mg bid	180	14	79.4% (143/180)	84.1% (143/170)	≥ 90%	31.1% (56/180)
Zhang et al[32], 2018	China	RCT	1^st	R 10 mg bid + MIN 100 mg bid + MTZ 400 mg tid + B 220 mg bid	94	14	84.0% (79/94)	87.8% (79/90)	≥ 90%	40.4% (38/94)
Zhang et al[32], 2018	China	RCT	1^st	R 10 mg bid + CLA 500 mg bid + AMX 1000 mg bid + B 220 mg bid	95	14	83.2% (79/95)	86.8% (79/91)	≥ 90%	41.1% (39/95)
Pu et al[33], 2018	China	Cohort study	1^st	R 10 mg bid + MIN 100 mg bid + AMX 1000 mg bid + B 220 mg bid	130	14	83.9% (109/130)	94.8% (109/115)	96.2% (125/130)	41.5% (54/130)
Pu et al[33], 2018	China	Cohort study	2^nd	R 10 mg bid + MIN 100 mg bid + AMX 1000 mg bid + B 220 mg bid	96	14	86.5% (83/96)	96.5% (83/86)	97.9% (94/96)	44.8% (43/96)
Xu et al[34], 2019	China	Cohort study	1^st	R 20mg bid + MIN 100mg bid + AMX 1000mg bid + B 300 mg bid	52	14	88.5% (46/52)	93.6% (44/47)	≥ 90%
Xu et al[34], 2019	China	Cohort study	2^nd	R 20mg bid + MIN 100mg bid + AMX 1000mg bid + B 300mg bid	28	14	82.1% (23/28)	95.7% (22/23)	≥ 80%
Li et al[35], 2019	China	RCT	≥ 2^nd	E 20mg bid + RIF 150mg bid + FUR 100mg tid	74	10	82.4% (61/74)	91.0% (61/67)	90.5% (67/74)
Li et al[35], 2019	China	RCT	≥ 2^nd	E 20mg bid + MIN 100mg bid + FUR 100mg tid + B 110mg qid	72	10	84.7% (61/72)	93.8% (61/65)	90.3% (65/72)
Zhang et al[36], 2019	China	RCT	1^st	R 10mg bid + MIN 100mg bid + AMX 1000mg bid + B 220mg bid	119	14	85.7% (102/119)	89.5% (102/114)	96.6% (115/119)	30% (36/120)
				R 10mg bid + MIN 100mg bid + MTZ 400mg tid + B 220mg bid	118	14	77.1% (91/118)	84.3% (91/108)	94.9% (112/118)	37.5% (45/120)
				R 10mg bid + CLA 500mg bid + AMX 1000mg bid + B 220 mg bid	1020	14	71.7% (86/120)	76.8% (86/112)	95.8% (115/120)	40.0% (48/120)
Zhang et al[37], 2022	China	RCT	1^st	R 10mg bid + MIN 100mg bid + MTZ 400mg tid + B 220mg bid	76	14	80.3% (61/76)	83.6% (61/73)	≥ 90%	47.4% (36/76)
Zhang et al[37], 2022	China	RCT	1^st	R 10mg bid + MIN 100mg bid + LEV 500mg qd + B 220mg bid	74	14	89.2% (66/74)	90.4% (66/73)	≥ 90%	33.8% (25/74)
Zhang et al[38], 2021	China	Cohort study	1^st	R 10mg bid + MIN 100mg bid + MTZ 400mg tid + B 220mg bid	175	14	72.0% (126/175)	86.3% (126/146)	≥ 90%	50.9% (89/175)
Huang et al[39], 2021	China	Cohort study	1^st	E 20mg bid + MIN 100mg bid + ONZ 500mg bid + B 220mg bid	50	14	96.0% (48/50)		≥ 90%
Huang et al[39], 2021	China	Cohort study	1^st	E 20mg bid + MIN 100mg bid + ONZ 500mg bid + B 220mg bid + Bifidobacterium Lactobacillus trifecta 2000mg bid	51	14	92.2% (47/51)
Cui et al[40], 2022	China	Cohort study	1^st	R 10mg bid + MIN 100mg bid + MTZ 400mg tid + B 220mg bid	28	14	71.4% (20/28)	87.0% (20/23)
Li et al[41], 2022	China	RCT	1^st	E 20mg bid + CLA 500mg bid +AMX 1000mg bid + B 200mg bid	91	10	80.2% (73/91)	89.0% (73/82)		6.7% (9/134)
				E 20mg bid + MIN 100mg bid + AMX 1000mg bid + B 200mg bid	43	10	81.4% (35/43)	87.5% (35/40)
				E 20mg bid + FUR 100mg bid + AMX 1000mg bid + B 200mg bid	67	10	85.1% (57/67)	90.5% (57/63)		7.5% (5/67)
Guo et al[42], 2023	China	Cohort study	1^st	E 20mg bid + MIN 100mg bid + AMX 750mg tid + B 200mg tid	25	14	84.0% (21/25)		≥ 90%
Guo et al[42], 2023	China	Cohort study	≥ 2^nd	E 20mg bid + MIN 100mg bid + AMX 750mg tid + B 200mg tid	65	14	86.2% (56/65)
Hao et al[43], 2022	China	Cohort study	≥ 2^nd	R 10mg bid + MIN 100mg bid + AMX 1000mg bid + B 300mg bid	80	14	78.8% (63/80)
Suo et al[23], 2023	China	RCT	1^st	E 20mg bid + MIN 100mg bid + MTZ 400mg qid + B 110mg qid	217	14	83.4% (181/217)	91.7% (177/193)	90.7% (195/215)	34.9% (75/215)	6.3% (4/63)
Suo et al[23], 2023	China	RCT	1^st	E 20mg bid + TET 500mg qid + MTZ 400mg qid + B 110mg qid	217	14	83.0% (180/217)	92.2% (176/191)	89.7% (192/214)	41.1% (88/214)	7.0% (5/71)
Zhang et al[25], 2023	China	RCT	1^st	E 20mg bid + MIN 100mg bid + MTZ 400mg qid + B 220mg bid	150	14	84.0% (126/150)	91.7% (122/133)	90.5% (134/148)	35.1% (52/148)	7% (3/43)
				E 20mg bid + MIN 100mg bid + CEF 500mg bid + B 220mg bid	150	14	82.7% (124/150)	90.9% (120/132)	91.8% (134/146)	22.6% (33/146)	8.5% (4/47)
				E 20mg bid + CEF 500mg bid + MTZ 400mg qid + B 220mg bid	150	14	82.0% (123/150)	88.2% (120/136)	91.9% (137/149)	28.9% (43/149)	9.1% (4/44)
Huang et al[24], 2023	China	RCT	≥ 2 ^nd	E 20mg bid + MIN 100mg bid + MTZ 400mg qid + B 220mg bid	184	14	88.0% (162/184)	98.0% (149/152)	88% (162/184)	55.4% (102/184)	0.7% (1/145)
Huang et al[24], 2023	China	RCT	≥ 2 ^nd	E 20mg bid + TET 500mg qid + MTZ 400mg qid + B 220mg bid	184	14	88.6% (163/184)	97.4% (150/154)	88.6% (163/184)	53.3% (98/184)	0.7% (1/143)

RCT: Randomized controlled trial; ITT: Intention-to-treat; PP: Per-protocol; R: Rabeprazole; CLA: Clarithromycin; AMX: Amoxicillin; MIN: Minocycline; MTZ: Metronidazole; FAR: Faropenem; RIF: Rifabutin; B: Bismuth; TNZ: Tinidazole; E: Esomeprazole; AMLZ: Omeprazole; FUR: Furazolidone; LEV: Levofloxacin; ONZ: Ornidazole; TET: Tetracycline; CEF: Cefuroxime.

Table 2 Pooled eradication rates

	Overall eradication rate % (95%CI)		Eradication rate for first-treatment patients % (95%CI)		Eradication rate for retreatment patients % (95%CI)
	Intention-to-treat analysis	Per-protocol analysis	Intention-to-treat analysis	Per-protocol analysis	Intention-to-treat analysis	Per-protocol analysis
Minocycline-containing regimen	82.3% (79.7%-85.1%)	90.0% (87.7%-92.4%)	83.6% (80.6%-86.7%)	90.5% (88.7%-92.3%)	82.3% (79.5%-85.2%)	90.8% (86.4%-95.4%)
Minocycline-containing combination regimen with nitroimidazole antibiotics	82.1% (77.9%-86.5%)	89.5% (86.0%-93.0%)	82.4% (77.9%-87.0%)	89.4% (86.9%-91.9%)	85.4% (81.0%-90.0%)	80.2% (56.8%-100.0%)
Minocycline-containing combination regimen with amoxicillin	83.8% (81.9%-85.9%)	89.9% (86.3%-93.6%)	85.9% (83.0%-89.0%)	92.7% (90.4%-95.1%)	82.7% (80.0%-85.5%)	90.9% (85.9%-96.1%)

CI: Confidence interval.

Citation: Zhou K, Li CL, Zhang H, Suo BJ, Zhang YX, Ren XL, Wang YX, Mi CM, Ma LL, Zhou LY, Tian XL, Song ZQ. Minocycline in the eradication of Helicobacter pylori infection: A systematic review and meta-analysis. World J Gastroenterol 2024; 30(17): 2354-2368
URL: https://www.wjgnet.com/1007-9327/full/v30/i17/2354.htm
DOI: https://dx.doi.org/10.3748/wjg.v30.i17.2354