Meta-Analysis
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 7, 2024; 30(17): 2354-2368
Published online May 7, 2024. doi: 10.3748/wjg.v30.i17.2354
Minocycline in the eradication of Helicobacter pylori infection: A systematic review and meta-analysis
Kai Zhou, Cai-Ling Li, Hua Zhang, Bao-Jun Suo, Yu-Xin Zhang, Xin-Lu Ren, Yu-Xin Wang, Chang-Min Mi, Ling-Ling Ma, Li-Ya Zhou, Xue-Li Tian, Zhi-Qiang Song
Kai Zhou, Cai-Ling Li, Hua Zhang, Bao-Jun Suo, Yu-Xin Zhang, Xin-Lu Ren, Yu-Xin Wang, Chang-Min Mi, Ling-Ling Ma, Li-Ya Zhou, Xue-Li Tian, Zhi-Qiang Song, Department of Gastroenterology, Peking University Third Hospital, Beijing 100191, China
Co-first authors: Zhou Kai and Cai-Ling Li.
Co-corresponding authors: Xue-Li Tian and Zhi-Qiang Song.
Author contributions: Zhou K and Song ZQ contributed to the research design; Zhou K was involved in the literature screening, quality assessment, and manuscript writing; Zhou K, Zhang H, and Tian XL participated to the statistical analysis; Li LC, Zhou LY, Tian XL, and Song ZQ edited the manuscript; Li CL contributed to literature mining; Li CL, Suo BJ, Zhang YX, Ren XL, Wang YX, Mi CM, and Ma LL were involved in the data analysis; Song ZQ contributed to the research concepts and funding acquisition; and all authors have read and approved the final manuscript. Zhou K and Li CL contributed equally to this work as co-first authors. The reasons are the following. First, the research was performed as a collaborative effort, and the designation of co-first authors authorship accurately reflects the distribution of responsibilities and burdens associated with the time and effort required to complete the study and the resultant paper. Second, co-first authors contributed efforts of equal substance throughout the research process. Song ZQ and Tian XL contributed equally to this work as co-corresponding authors. The reasons are the following. First, they played a key role in coordinating the research team. Second, they made a great contribution to the original innovation of the article. In summary, we believe that designating Zhou K and Li CL as co-first authors, Song ZQ and Tian XL as co-corresponding authors is fitting for our manuscript as it accurately reflects our team’s collaborative spirit, equal contributions, and diversity.
Supported by National Natural Science Foundation of China, No. 82170562; Beijing Natural Science Foundation, No. 7232199; Capital’s Funds for Health Improvement and Research, No. 2022-2-4093; Youth Incubation Fund of Peking University Third Hospital, No. BYSYFY2021003; and Key Laboratory for Helicobacter pylori Infection and Upper Gastrointestinal Diseases in Beijing, No. BZ0371.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhi-Qiang Song, MD, Doctor, Department of Gastroenterology, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing 100191, China. szqinputh@163.com
Received: January 31, 2024
Revised: March 4, 2024
Accepted: April 10, 2024
Published online: May 7, 2024
Abstract
BACKGROUND

Difficulty in obtaining tetracycline, increased adverse reactions, and relatively complicated medication methods have limited the clinical application of the classic bismuth quadruple therapy. Therefore, the search for new alternative drugs has become one of the research hotspots. In recent years, minocycline, as a semisynthetic tetracycline, has demonstrated good potential for eradicating Helicobacter pylori (H. pylori) infection, but the systematic evaluation of its role remains lacking.

AIM

To explore the efficacy, safety, and compliance of minocycline in eradicating H. pylori infection.

METHODS

We comprehensively retrieved the electronic databases of PubMed, Embase, Web of Science, China National Knowledge Infrastructure, SinoMed, and Wanfang database as of October 30, 2023, and finally included 22 research reports on H. pylori eradication with minocycline-containing regimens as per the inclusion and exclusion criteria. The eradication rates of H. pylori were calculated using a fixed or a random effect model, and the heterogeneity and publication bias of the studies were measured.

RESULTS

The single-arm meta-analysis revealed that the minocycline-containing regimens achieved good overall H. pylori eradication rates, reaching 82.3% [95% confidence interval (CI): 79.7%-85.1%] in the intention-to-treat analysis and 90.0% (95%CI: 87.7%-92.4%) in the per-protocol analysis. The overall safety and compliance of the minocycline-containing regimens were good, demonstrating an overall incidence of adverse reactions of 36.5% (95%CI: 31.5%-42.2%). Further by traditional meta-analysis, the results showed that the minocycline-containing regimens were not statistically different from other commonly used eradication regimens in eradication rate and incidence of adverse effects. Most of the adverse reactions were mild to moderate and well-tolerated, and dizziness was relatively prominent in the minocycline-containing regimens (16%).

CONCLUSION

The minocycline-containing regimens demonstrated good efficacy, safety, and compliance in H. pylori eradication. Minocycline has good potential to replace tetracycline for eradicating H. pylori infection.

Keywords: Helicobacter pylori, Minocycline, Eradication, Safety, Resistance

Core Tip: Regarding the utilization of minocycline in the eradication therapy of Helicobacter pylori (H. pylori) infection, there is a lack of literature summarizing the potential and role of minocycline in the eradication of H. pylori infection. This is the first comprehensive account of the role, efficacy, and current state of research on minocycline in the eradication therapy of H. pylori infection by traditional meta-analysis as well as single-arm meta-analysis methods. We have summarized this minocycline in terms of bactericidal mechanism, pharmacodynamics, pharmacokinetics, drug resistance, eradication efficacy, safety and compliance.