{
  "abstract": "Background: Vonoprazan is pharmacologically distinct from proton pump inhibitors and is increasingly incorporated into Helicobacter pylori eradication regimens. Previous meta-analyses of probiotic adjuncts pooled heterogeneous acid-suppressive agents, antibiotic backbones, probiotic products, and treatment durations, limiting inference about the incremental effect of probiotics when the vonoprazan-based regimen is otherwise fixed.\n\nObjective: To determine whether adjunctive probiotics improve tolerability and eradication outcomes when randomized groups receive an otherwise identical vonoprazan-based H. pylori regimen.\n\nMethods: We searched eight bibliographic databases and three trial registries from inception through 15 July 2026. Eligible studies were randomized trials in adults comparing an identical vonoprazan-based regimen with or without concurrently administered probiotics. Risk ratios were pooled using restricted maximum-likelihood random-effects models with Hartung-Knapp confidence intervals. We also reported 95% prediction intervals, absolute effects, outcome-specific RoB 2 assessments, sensitivity analyses, and GRADE certainty ratings.\n\nResults: Nine studies involving 1,270 participants were included. Adjunctive probiotics reduced overall adverse events (5 studies, 611 participants; RR = 0.30, 95%CI: 0.17–0.53; P = 0.004; I ² = 0%; 95% prediction interval: 0.12–0.79), corresponding to 182 fewer affected participants per 1,000 treated (moderate-certainty evidence). Intention-to-treat eradication was slightly higher with probiotics (7 studies, 910 participants; RR = 1.09, 95% CI: 1.00–1.19; I ² = 47.8%), but the prediction interval crossed the null and sensitivity analyses were not statistically significant. Per-protocol eradication showed little or no difference (5 studies, 698 participants; RR = 1.03, 95%CI: 0.97–1.09), and good adherence was not clearly improved.\n\nConclusion: Among Chinese adults, adjunctive probiotics probably reduce overall adverse events during vonoprazan-based H. pylori eradication therapy. The available evidence does not establish a reliable improvement in eradication success, and applicability to populations outside China remains uncertain.\n\nPROSPERO Registration: CRD420261450405.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Pharmacy, Ya’an Yucheng District People’s Hospital (Second People’s Hospital of Ya’an City)",
    "Department of Pharmacy, Sichuan Provincial Maternity and Child Healthcare Hospital and the Affiliated Women’s and Children’s Hospital of Chengdu Medical College"
  ],
  "article_type": "systematic review",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Chun-Jiang Lin"
    },
    {
      "affs": [
        0
      ],
      "name": "Peng-Yuan Ren"
    },
    {
      "affs": [
        0
      ],
      "name": "Hong-Yu Chen"
    },
    {
      "affs": [
        0
      ],
      "name": "Ming-Qiao Zheng"
    },
    {
      "affs": [
        1
      ],
      "name": "Yong-Xian Jiang"
    },
    {
      "affs": [
        1
      ],
      "name": "Gen Li"
    },
    {
      "affs": [
        1
      ],
      "name": "Min Fu"
    },
    {
      "affs": [
        1
      ],
      "name": "Ya-Hui Guo"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/bmx19tk6akykr.bib",
  "cited_by": 0,
  "doi": "10.3389/fphar.2026.1946885",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13724370/?tool=EBI",
  "id": "bmx19tk6akykr",
  "issns": [
    "1663-9812"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fphar.2026.1946885/full",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Systematic Review"
    ],
    [
      "openalex",
      "2746|Helicobacter pylori-related gastroenterology studies"
    ]
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  "openalex": "W7222964387",
  "pdf_url": "https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2026.1946885/pdf",
  "pmcid": "PMC13724370",
  "pmid": "42973601",
  "published": "2026-10-19",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/bmx19tk6akykr.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:06Z",
      "native_id": "10.3389/fphar.2026.1946885",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fphar.2026.1946885/full"
    },
    {
      "first_seen": "2026-11-03T15:20:51Z",
      "native_id": "PMC:PMC13724370",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13724370"
    },
    {
      "first_seen": "2026-11-04T12:22:57Z",
      "native_id": "PMC13724370",
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      "url": "https://doi.org/10.3389/fphar.2026.1946885"
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    {
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      "url": "https://europepmc.org/article/MED/42973601"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Helicobacter pylori-related gastroenterology studies",
      "subfield": "surgery"
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  ],
  "title": "Adjunctive probiotics may reduce adverse events during vonoprazan-based Helicobacter pylori eradication: a systematic review and meta-analysis",
  "title_text": "Adjunctive probiotics may reduce adverse events during vonoprazan-based Helicobacter pylori eradication: a systematic review and meta-analysis",
  "type": "peer-reviewed",
  "updated_at": "2026-11-04T15:20:48Z",
  "url": "https://research.draconitic.com/paper/bmx19tk6akykr",
  "venue": "Frontiers in Pharmacology",
  "versions": []
}