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World J Gastroenterol. Sep 28, 2026; 32(36): 122851
Published online Sep 28, 2026. doi: 10.3748/wjg.122851
Published online Sep 28, 2026. doi: 10.3748/wjg.122851
Low-dose vs standard-dose minocycline in bismuth quadruple therapy for first-line Helicobacter pylori eradication: A randomized controlled, noninferiority trial
Ya-Na Zhu, Lu Li, Rao-Rao Wang, Ying-Lan Ji, Ya-Ping Wang, Hao-Yu Zhai, Yong Jiang, Department of Gastroenterology, The Second Hospital of Tianjin Medical University, Tianjin 300211, China
Yong-Bing Wang, Department of Gastroenterology, Yunyang People's Hospital, Chongqing 404500, China
Ya-Di Ren, Department of Gastroenterology, Handan Central Hospital, Handan 056000, Hebei Province China
Co-first authors: Ya-Na Zhu and Yong-Bing Wang.
Co-corresponding authors: Hao-Yu Zhai and Yong Jiang.
Author contributions: Zhu YN and Wang YB contribute equally to this study as co-first authors; Jiang Y and Zhai HY contribute equally to this study as co-corresponding authors; Zhu YN designed the study and write the manuscript; Wang YB conceived the study, performed the statistical analysis, and critically revised the manuscript; Li L, Ren YD, Wang RR, Ji YL, and Wang YP collected the data and performed statistical analysis; Li L, Jiang Y, and Zhai HY supported editing of the original draft and critically revised the manuscript.
AI contribution statement: Portions of this manuscript were edited using AI tools solely for language refinement. The authors carefully reviewed and verified all AI-assisted outputs and take full responsibility for the scientific content of the manuscript.
Supported by Tianjin Municipal Education Commission Scientific Research Program, No. 2023KJ025.
Institutional review board statement: This study was approved by the Ethics Committee of The Second Hospital of Tianjin Medical University, No. KY2024K340.
Clinical trial registration statement: The trial was registered at the Chinese Clinical Trial Registry (www.chictr.org.cn), No. ChiCTR2500100094.
Informed consent statement: All participants provided written informed consent prior to enrollment in the study.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: Deidentified individual participant data and study materials are available from the corresponding author upon reasonable request for academic purposes.
Corresponding author: Yong Jiang, MD, Department of Gastroenterology, The Second Hospital of Tianjin Medical University, No. 23 Pingjiang Road, Tianjin 300211, China.
Received: April 30, 2026
Revised: June 23, 2026
Accepted: July 6, 2026
Published online: September 28, 2026
Processing time: 114 Days and 7.9 Hours
Revised: June 23, 2026
Accepted: July 6, 2026
Published online: September 28, 2026
Processing time: 114 Days and 7.9 Hours
Core Tip
Core Tip: The optimal dose of minocycline in bismuth-containing quadruple therapy remains uncertain. This study demonstrates that a low-dose minocycline-based regimen is noninferior to the standard-dose regimen in treatment-naïve Helicobacter pylori infection, while offering a superior safety profile and better cost-effectiveness, supporting its clinical utility.