Thirteen RCTs were included in meta-analyses (n=3,271 patients). The quality score of RCTs ranged from 1 to 5 points; only one RCT was judged as high quality. The follow-up duration ranged from four weeks to six months.
For adult patients, sequential therapy was associated with a significant increase in eradication of Helicobacter pylori infection compared with triple therapy (OR 2.99, 95% CI 2.47 to 3.62; NNT 6, 95% CI 5 to 7; ten RCTs; n=3,011 patients).
For child and adolescent patients, sequential therapy was associated with a non-significant increase in eradication of Helicobacter pylori infection compared with triple therapy (OR 1.98, 95% CI 0.96 to 4.07; three RCTs; n=260 patients).
No significant heterogeneity was found for these outcomes. There was no evidence of publication bias.
Results of subgroup analyses were also reported.
There was no significant difference in the rate of side effects between sequential therapy and triple therapy.