Pantoprazole based therapies in Helicobacter pylori eradication: a systematic review and meta-analysis

Eur J Gastroenterol Hepatol. 2004 Jan;16(1):89-99. doi: 10.1097/00042737-200401000-00014.


Aim: To perform a systematic review on the efficacy of pantoprazole based therapies in Helicobacter pylori eradication, and to conduct a meta-analysis comparing the efficacy of pantoprazole and other proton pump inhibitors (PPIs) when co-prescribed with antibiotics.

Methods: Studies evaluating pantoprazole combined with antibiotics were considered. Only randomized clinical trials comparing pantoprazole and other PPIs when co-prescribed with antibiotics, and differing only in the PPI (pantoprazole vs other), were eligible for inclusion in the meta-analysis. Bibliographical searches in several electronic databases, and manual search of abstracts from congresses, were conducted. The percentage (weighted mean) of patients with eradication success was calculated. Meta-analysis was performed combining the odds ratios (ORs) of the individual studies in a global OR.

Results: The mean eradication rate with pantoprazole plus clarithromycin for 14 days was 60%. Cure rates with 7 day pantoprazole based triple regimens were higher: pantoprazole, amoxicillin and clarithromycin (78%); pantoprazole, clarithromycin and nitroimidazole (84%); and pantoprazole, amoxicillin and nitroimidazole (74%). Twelve studies comparing pantoprazole and other PPIs were selected for the meta-analysis, including 534 and 603 patients, respectively. The mean eradication rate for H. pylori using pantoprazole plus antibiotics was 83%, and 81% when other PPIs were used (OR = 1; 95% confidence interval (CI) from 0.61 to 1.64). When sub-analysis was performed, including only studies comparing pantoprazole with omeprazole, or pantoprazole with lansoprazole, differences were also statistically non-significant. The meta-analysis of the six studies prescribing equivalent doses of all PPIs demonstrated similar results with pantoprazole and with other PPIs (OR = 1.07; 95% CI from 0.71 to 1.62), the results being statistically homogeneous.

Conclusions: Pantoprazole achieves similar cure rates to those of omeprazole and lansoprazole when co-prescribed with antibiotics for the eradication of H. pylori infection.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • 2-Pyridinylmethylsulfinylbenzimidazoles
  • Anti-Infective Agents / therapeutic use*
  • Benzimidazoles / therapeutic use*
  • Drug Therapy, Combination
  • Enzyme Inhibitors / therapeutic use*
  • Helicobacter Infections / drug therapy*
  • Helicobacter pylori* / drug effects
  • Humans
  • Omeprazole / analogs & derivatives
  • Pantoprazole
  • Proton Pump Inhibitors
  • Randomized Controlled Trials as Topic
  • Sulfoxides / therapeutic use*


  • 2-Pyridinylmethylsulfinylbenzimidazoles
  • Anti-Infective Agents
  • Benzimidazoles
  • Enzyme Inhibitors
  • Proton Pump Inhibitors
  • Sulfoxides
  • Pantoprazole
  • Omeprazole