Evaluation of folic acid for H. pylori-associated chronic atrophic gastritis

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Created On: 30/07/2025

This systematic review and meta-analysis determined folic acid's efficiency and safety in treating chronic atrophic gastritis linked with Helicobacter pylori (H. pylori).

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Key take away

Folic acid remarkably improves treatment efficacy and supports gastric mucosal healing in patients with H. pylori-linked chronic atrophic gastritis.

Background

This systematic review and meta-analysis determined folic acid's efficiency and safety in treating chronic atrophic gastritis linked with Helicobacter pylori (H. pylori).

Method

Researchers focused on randomized controlled trials (RCTs), including published studies, unpublished clinical data, and conference proceedings. Literature searches were carried out across multiple databases—Wanfang, PubMed, Embase, Web of Science, VIP, and China National Knowledge Infrastructure (CNKI)—covering all records up to June 2024. Data extraction was completed using a standardized form, and statistical analysis was carried out using RevMan 5.4 and STATA 15.1. Risk ratios (RR) along with 95% confidence intervals (CI) were employed to assess efficacy and safety outcomes.

Result

A total of 16 RCTs involving 1,364 volunteers met the inclusion criteria. Folic acid supplementation exhibited a substantially higher overall effectiveness rate when compared to standard therapy (95.09% vs. 79.06%; pooled RR = 1.19) and a lower incidence of adverse events (11.64% vs. 14.04%; RR = 0.86). Additionally, folic acid illustrated a greater capacity to boost gastric function and facilitate mucosal healing (Mean difference = 27.20).

Conclusion

For patients with H. pylori-associated chronic atrophic gastritis, early initiation of anti-H. pylori therapy alongside folic acid supplementation is recommended. The use of gastric mucosal protective agents may further improve treatment outcomes and should be considered for those with significant adverse reactions.