Six RCTs (n=1,207) were included in the review.
In terms of the quality assessment, the Chalmers scores ranged from 0.25 to 0.88 (maximum score 1) and all studies met two or three of the Jadad criteria (not presented as a score).
A significant benefit of eradication was found in comparison with no eradication (5 RCTs, n=939; OR 0.43, 95% CI: 0.20, 0.93). Significant heterogeneity was present for this outcome.
The benefit of eradication was significant for new NSAID users (3 RCTs, n=532; OR 0.26, 95% CI: 0.14, 0.49) but not for previous users (2 RCTs, n=407). Eradication significantly benefited patients without a history of ulcer (3 RCTs, n=572), reduced the risk of both duodenal and gastric ulcers (4 RCTs), and reduced the risk of bleeding ulcers (4 RCTs).
Two RCTs (n=385) compared eradication with PPI treatment; the pooled analysis showed a significant benefit of PPI treatment (OR 7.43, 95% CI: 1.27, 43.64) without significant heterogeneity.