{
  "abstract": "Helicobacter pylori (H. pylori) has been implicated in immune thrombocytopenia (ITP), but the magnitude and reliability of benefit from eradication therapy in randomized trials remain uncertain. We performed a PRISMA-guided, PROSPERO-registered (CRD420251149478) systematic review and meta-analysis restricted to randomized controlled trials (RCTs) comparing H. pylori eradication versus control in ITP. Random-effects models generated risk ratios (RRs) for categorical outcomes: complete response (CR), partial response (PR), overall response (CR + PR), no/minimal response (NR), and 1-year relapse, and mean differences (MDs) for platelet-count change at approximately 6 months. Heterogeneity was assessed using I² and τ². Robustness was evaluated using leave-one-out analyses and additional post hoc sensitivity analyses for clinically or statistically influential trials. Small-study effects were explored using funnel plots and Egger/Begg tests when sufficient studies were available. Eight RCTs (n = 297) across Asia and Latin America met inclusion. Eradication increased CR without statistical significance (RR 1.45, 95% CI 0.87-2.41; I²=40.9%) and did not change PR (RR 0.88, 0.57-1.36; I²=0%) or overall response (RR 1.04, 0.90-1.20; I²=35.9%). NR was significantly lower with eradication (RR 0.65, 0.49-0.85; I²=14.8%). Relapse at 1 year trended lower but was not significant (RR 0.49, 0.24-1.01; I²=0%). Platelet counts rose more after eradication at ~ 6 months (MD + 61.9 × 10⁹/L, 36.1-87.7; I²=74.9%). Leave-one-out analyses did not materially change the overall conclusions. In a post hoc sensitivity analysis excluding Tang 2013 from the platelet-change outcome because of unusually small reported SDs, the platelet-count benefit remained significant and heterogeneity decreased to I²=0%. Funnel plots and formal tests suggested small-study effects for CR and overall response, indicating that these estimates may be inflated; no/minimal response showed no evidence of asymmetry. In randomized trials, H. pylori eradication in ITP was associated with a lower risk of no/minimal response and a greater platelet-count increase, while effects on CR, PR, overall response, and relapse remained uncertain. Because CR and overall response showed evidence of small-study effects, the most robust categorical finding was the reduction in no/minimal response. Larger, adequately powered trials are needed to define which patients are most likely to benefit and to confirm the durability of platelet response.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Medicine, Faculty of Medicine and Allied Medical Sciences, An-Najah National University, Nablus, P400, Palestine. MoathJHattab@Gmail.com.",
    "Department of Medicine, Faculty of Medicine and Allied Medical Sciences, An-Najah National University, Nablus, P400, Palestine."
  ],
  "article_type": "systematic review",
  "arxiv": null,
  "author_total": 11,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Moath Hattab",
      "orcid": "0009-0005-2835-0429"
    },
    {
      "affs": [
        1
      ],
      "name": "Fathi Milhem"
    },
    {
      "affs": [
        1
      ],
      "name": "Hammam Jallad"
    },
    {
      "affs": [
        1
      ],
      "name": "Mahmoud Suleiman"
    },
    {
      "affs": [
        1
      ],
      "name": "Halla Albada"
    },
    {
      "affs": [
        1
      ],
      "name": "Ayman Khaled"
    },
    {
      "affs": [
        1
      ],
      "name": "Sakeena Saife"
    },
    {
      "affs": [
        1
      ],
      "name": "Mira Hallak"
    },
    {
      "affs": [
        1
      ],
      "name": "Sarah Saife"
    },
    {
      "affs": [
        1
      ],
      "name": "Fadi Abualhommos"
    },
    {
      "affs": [
        1
      ],
      "name": "Mohammad Bdair"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/3j791zkyb77sc.bib",
  "cited_by": 1,
  "doi": "10.1007/s00277-026-07187-7",
  "fulltext_url": "https://europepmc.org/articles/PMC13690900",
  "id": "3j791zkyb77sc",
  "issns": [
    "0939-5555",
    "1432-0584"
  ],
  "landing_url": "https://europepmc.org/article/MED/42911235",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RC31-1245"
    ],
    [
      "openalex",
      "2720|Platelet Disorders and Treatments"
    ]
  ],
  "openalex": "W7171452725",
  "pdf_url": "https://europepmc.org/articles/PMC13690900?pdf=render",
  "pmcid": "PMC13690900",
  "pmid": "42911235",
  "published": "2026-07-01",
  "publisher": "Springer",
  "ris": "https://research.draconitic.com/paper/3j791zkyb77sc.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:14Z",
      "native_id": "MED:42911235",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42911235"
    },
    {
      "first_seen": "2026-10-30T13:45:39Z",
      "native_id": "edc9b63861a845228c4e236608495dc1",
      "source": "doaj",
      "url": "https://doi.org/10.1007/s00277-026-07187-7"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2720|Platelet Disorders and Treatments",
      "subfield": "general"
    }
  ],
  "title": "Helicobacter pylori eradication for immune thrombocytopenia reduces non-response and raises platelet counts: Meta-analysis of randomized trials.",
  "title_text": "Helicobacter pylori eradication for immune thrombocytopenia reduces non-response and raises platelet counts: Meta-analysis of randomized trials.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:45:39Z",
  "url": "https://research.draconitic.com/paper/3j791zkyb77sc",
  "venue": "Annals of hematology",
  "versions": []
}