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Modified BQT markedly improves H. pylori eradication rates when compared to conventional triple therapy, with similar safety and better adherence than classic BQT.
In the face of rising Helicobacter pylori (H. pylori) elimination failure, a new systematic review and meta-analysis offers promising evidence that modified bismuth quadruple therapy (mBQT)—which involves adding bismuth to conventional triple therapy—may offer superior treatment outcomes for H. pylori treatment-naïve patients.
Researchers explored randomized controlled trials (RCTs) across Embase, PubMed, and the Cochrane Library. The analysis compared mBQT with three treatment categories:
A total of 35 RCTs involving 43 trials and over 17,000 patients were included, with 9,162 patients in the intention-to-treat and 8,449 in the per-protocol analyses. The results illustrated that mBQT considerably outperformed standard triple therapy in eradication rates (84.8% vs. 74.1%). When compared to non-BQT and cBQT regimens, mBQT showed statistically similar elimination rates (80.8% vs. 80.2% and 81.5% vs. 83.0%, respectively), with no vital difference in adverse drug events (25.4% vs. 27.5%).
Notably, patient adherence to mBQT was quite higher than to cBQT (96.4% vs. 93.3%). Thus, mBQT is a highly effective, well-tolerated, and adherent first-line treatment strategy for H. pylori eradication in treatment-naïve patients, offering a valuable alternative in an era of growing antibiotic resistance.
Microorganisms
Efficacy and Safety of Modified Bismuth Quadruple Therapy for First-Line Helicobacter pylori Eradication: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Jun-Hyung Cho et al.
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