Evidence map›Paper›PMID 27102658›Full record

ReviewGastroenterology2016

The Toronto Consensus for the Treatment of Helicobacter pylori Infection in Adults.

Carlo A Fallone, Naoki Chiba, Sander Veldhuyzen van Zanten, Lori Fischbach, Javier P Gisbert, Richard H Hunt, Nicola L Jones, Craig Render, Grigorios I Leontiadis, Paul Moayyedi and 1 more

2 registry-linked trialsAbstract readConsensus StatementReview
PubMed Publisher
In one paragraph

Review in Gastroenterology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 417 papers, 16 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
417citing papers in PubMed, 16 pooled it
–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.

NCT02959255 phase4completednot on this mapstarted 2017, after this paper: background citation

A Greek, Single Center, Randomized, Double Blind Controlled Clinical Study Comparing the 10-day Versus the 14-day Concomitant Proton Pump Inhibitor [PPI] + Amoxicillin + Metronidazole + Clarithromycin (PAMC) Therapeutic Scheme as First-line Treatment Strategy for the Eradication of H. Pylori Infection

TypeinterventionalSponsorElpen Pharmaceutical Co. Inc.Ran2017 to 2017Enrolled364ConditionsHelicobacter Pylori InfectionArmsEsomeprazole
NCT05664685 phase4completednot on this mapstarted 2022, after this paper: background citation

Optimized Bismuth Quadruple Therapy vs Triple Standard Therapy for Helicobacter Pylori Eradication: Clinical Efficacy Randomized Trial

TypeinterventionalSponsorPontificia Universidad Catolica de ChileRan2022 to 2024Enrolled127ConditionsHelicobacter Pylori InfectionArmsOptimized bismuth quadruple therapy, Control
3 · Its place in the literature

Who cites it

417 citing papers in PubMed, 16 syntheses or guidelines pooled it.

  1. Pooled it
  2. [Evidence-Based Guidelines for the Diagnosis and Treatment ofThe Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi · 2026
    Guideline
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  7. The effect of supplementing withFrontiers in medicine · 2024
    Pooled it
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  9. Guidelines on optimizing the use of proton pump inhibitors: PPI stewardship.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2023
    Guideline
  10. Pooled it
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  12. Effectiveness ofWorld journal of gastroenterology · 2023
    Pooled it
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  15. Relationship ofCanadian journal of gastroenterology & hepatology · 2023
    Pooled it
  16. High-Dose Dual Therapy Versus Bismuth-Containing Quadruple Therapy for the Treatment of Helicobacter pylori Infection: A Systematic Review with Meta-Analysis.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2022
    Pooled it
  17. Trial
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  19. Vonoprazan-Amoxicillin Dual Therapy with or WithoutInfection and drug resistance · 2026
    Trial
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357 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Carlo A FalloneDivision of Gastroenterology, McGill University Health Centre, McGill University, Montreal, Quebec, Canada. Electronic address: carlo.fallone@mcgill.ca.
Naoki ChibaGuelph GI and Surgery Clinic, Guelph, Ontario, Canada; Division of Gastroenterology, McMaster University, Hamilton, Ontario, Canada.
Sander Veldhuyzen van ZantenDivision of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
Lori FischbachDepartment of Epidemiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Javier P GisbertGastroenterology Service, Hospital Universitario de la Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP) and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain.
Richard H HuntDivision of Gastroenterology, McMaster University, Hamilton, Ontario, Canada; Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Ontario, Canada.
Nicola L JonesDivision of Gastroenterology, Hepatology, and Nutrition, The Hospital for Sick Children, Departments of Paediatrics and Physiology, University of Toronto, Toronto, Ontario, Canada.
Craig RenderKelowna General Hospital, Kelowna, British Columbia, Canada.
Grigorios I LeontiadisDivision of Gastroenterology, McMaster University, Hamilton, Ontario, Canada; Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Ontario, Canada.
Paul MoayyediDivision of Gastroenterology, McMaster University, Hamilton, Ontario, Canada; Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Ontario, Canada.
John K MarshallDivision of Gastroenterology, McMaster University, Hamilton, Ontario, Canada; Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Ontario, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND &

aimsHelicobacter pylori infection is increasingly difficult to treat. The purpose of these consensus statements is to provide a review of the literature and specific, updated recommendations for eradication therapy in adults.

methodsA systematic literature search identified studies on H pylori treatment. The quality of evidence and strength of recommendations were rated according to the Grading of Recommendation Assessment, Development and Evaluation (GRADE) approach. Statements were developed through an online platform, finalized, and voted on by an international working group of specialists chosen by the Canadian Association of Gastroenterology.

resultsBecause of increasing failure of therapy, the consensus group strongly recommends that all H pylori eradication regimens now be given for 14 days. Recommended first-line strategies include concomitant nonbismuth quadruple therapy (proton pump inhibitor [PPI] + amoxicillin + metronidazole + clarithromycin [PAMC]) and traditional bismuth quadruple therapy (PPI + bismuth + metronidazole + tetracycline [PBMT]). PPI triple therapy (PPI + clarithromycin + either amoxicillin or metronidazole) is restricted to areas with known low clarithromycin resistance or high eradication success with these regimens. Recommended rescue therapies include PBMT and levofloxacin-containing therapy (PPI + amoxicillin + levofloxacin). Rifabutin regimens should be restricted to patients who have failed to respond to at least 3 prior options.

conclusionsOptimal treatment of H pylori infection requires careful attention to local antibiotic resistance and eradication patterns. The quadruple therapies PAMC or PBMT should play a more prominent role in eradication of H pylori infection, and all treatments should be given for 14 days.

Indexed as

Helicobacter pyloriAdultAmoxicillinAnti-Infective AgentsBismuthCanadaClarithromycinDrug Administration ScheduleDrug Therapy, CombinationHelicobacter InfectionsHumansLevofloxacinMetronidazoleProton Pump InhibitorsTetracyclineAmoxicillinAnti-Infective AgentsBismuthClarithromycinLevofloxacinMetronidazoleProton Pump InhibitorsTetracyclineAmoxicillinBismuthClarithromycinEradicationHelicobacter pyloriLevofloxacinMetronidazoleProton Pump InhibitorResistanceRifabutinTetracycline

Identifiers

PMID27102658

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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 OpenQuestion graph.