Evidence mapPaperPMID 41534943Full record

SynthesisBMJ open gastroenterology2026

Comparative efficacy, safety and compliance with dual, triple and quadruple therapy as the first-line treatment regimens for

Iqbal Taufiqqurrachman, Ari Fahrial Syam, Hasan Maulahela, Murdani Abdullah, Takashi Matsumoto, Muhammad Miftahussurur, Yoshio Yamaoka

Abstract readComparative StudyNetwork Meta-AnalysisSystematic Review
In one paragraph

Synthesis in BMJ open gastroenterology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Iqbal TaufiqqurrachmanDepartment of Environmental and Preventive Medicine, Oita University Faculty Of Medicine Graduate School of Medicine, Yufu, Japan.
Ari Fahrial SyamDivision of Gastroenterology, Department of Internal Medicine, Rumah Sakit Umum Pusat Nasional Dr Cipto Mangunkusumo, Central Jakarta, Indonesia.
Hasan MaulahelaDivision of Gastroenterology, Department of Internal Medicine, Rumah Sakit Umum Pusat Nasional Dr Cipto Mangunkusumo, Central Jakarta, Indonesia.
Murdani AbdullahDivision of Gastroenterology, Department of Internal Medicine, Rumah Sakit Umum Pusat Nasional Dr Cipto Mangunkusumo, Central Jakarta, Indonesia.
Takashi MatsumotoDepartment of Environmental and Preventive Medicine, Oita University Faculty Of Medicine Graduate School of Medicine, Yufu, Japan.
Muhammad MiftahussururGastroentero-Hepatology Division, Department of Internal Medicine, Airlangga University Faculty of Medicine, Surabaya, Indonesia.
Yoshio YamaokaDepartment of Environmental and Preventive Medicine, Oita University Faculty Of Medicine Graduate School of Medicine, Yufu, Japan yyamaoka@oita-u.ac.jp.ORCID http://orcid.org/0000-0002-1222-5819

Funding

REGULATION OF CXC CHEMOKINE EXPRESSION BY H. PYLORIR01DK062813 · NIDDK · BAYLOR COLLEGE OF MEDICINE · PI YAMAOKA, YOSHIO · 2004 to 2013
$3.0M
NIDDK NIH HHS R01 DK062813
6 · The paper itself

Abstract

objectiveTo assess the efficacy, safety and compliance with dual, triple and quadruple therapy first-line regimens for

designA systematic review and network meta-analysis (NMA) reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses NMA guidance. DATA SOURCES: PubMed, Cochrane Library, ProQuest and Scopus were searched until 12 October 2025. ELIGIBILITY CRITERIA: Randomised controlled trials (RCTs) published in English that measured the eradication rate, adverse events and compliance rates of dual therapy compared with triple or quadruple therapy for DATA EXTRACTION AND SYNTHESIS: Data extraction and risk-of-bias assessment were performed by two independent reviewers. The data were analysed and represented as pooled ORs. Heterogeneity was assessed using meta-regression and trim-and-fill analyses.

resultsPairwise meta-analysis of 56 RCTs showed that dual therapy had no different eradication rates than triple therapy (intention-to-treat (ITT): OR 0.88, 95% CI 0.60 to 1.29; per-protocol (PP): OR 0.76, 95% CI 0.46 to 1.25). Dual therapy outperformed quadruple therapy (OR 1.20, 95% CI 1.04 to 1.39) with fewer adverse events (OR 0.32, 95% CI 0.28 to 0.38) and higher compliance rates (OR: 1.49, 95% CI 1.26 to 1.76). Based on the NMA, RAC-7 has the highest probability of effective treatment for both ITT (P-score=0.9436) and PP (P-score=0.9545).

conclusionDual therapy represents a promising first-line option, demonstrating comparable efficacy and adverse event rates with higher compliance, although triple therapy showed the highest probability of being the most effective first-line regimen in the NMA, followed by quadruple therapy. Further studies in non-Asian populations, along with resistance-guided treatment approaches, are needed to refine global eradication strategies.

Indexed as

Anti-Bacterial AgentsHelicobacter InfectionsHelicobacter pyloriProton Pump InhibitorsDrug Therapy, CombinationHumansMedication AdherenceRandomized Controlled Trials as TopicTreatment OutcomeAnti-Bacterial AgentsProton Pump InhibitorsAntibiotic TherapyDrug ResistanceHelicobacter pyloriHelicobacter pylori InfectionHelicobacter pylori - Treatment

Identifiers

PMID41534943
PMCPMC12815173

What Socratic holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.