Efficacy analysis of folic acid in chronic atrophic gastritis with Helicobacter pylori infection: a systematic review and meta-analysis

Abstract Background Current data indicate that supplements such as folic acid play a significant role in treating chronic atrophic gastritis (CAG). However, no meta-analysis article evaluates its efficacy comprehensively. Therefore, we conducted a meta-analysis to compare the effectiveness and safet...

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Main Authors: Hui Li, Jincheng Li, Mingyu Lai
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Gastroenterology
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Online Access:https://doi.org/10.1186/s12876-025-03644-1
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author Hui Li
Jincheng Li
Mingyu Lai
author_facet Hui Li
Jincheng Li
Mingyu Lai
author_sort Hui Li
collection DOAJ
description Abstract Background Current data indicate that supplements such as folic acid play a significant role in treating chronic atrophic gastritis (CAG). However, no meta-analysis article evaluates its efficacy comprehensively. Therefore, we conducted a meta-analysis to compare the effectiveness and safety of folic acid in the treatment of CAG with Helicobacter pylori (H. pylori) infection. Methods Using a systematic review method, consider randomized controlled trials (RCT), including clinical trial reports, unpublished clinical trial data, and conference papers. A comprehensive search of the literature was conducted from all years up to June 2024. We searched PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Vip, and Wanfang databases. Data were extracted using a pre-designed extraction tool and analysis was undertaken using RevMan5.4 and STAT15.1. Efficacy and safety outcomes were evaluated using risk ratio (RR) and 95% confidence intervals (CI). Results 16 randomized controlled trials with 1364 patients were included. Compared with conventional therapy, folic acid therapy had a higher total effective rate (95.09% vs.79.06%, pooled RR = 1.19, 95% CI: 1.12–1.26, p < 0.00001) and lower incidence of adverse events (11.64% vs. 14.04%, RR = 0.86, 95% CI: 0.46–1.60, p = 0.64). Moreover, folic acid can better improve gastric function and repair gastric mucosa (MD = 27.20, 95%CI:23.84–30.56, p < 0.00001). Conclusions For HP-related CAG, anti-HP treatment and folic acid supplementation should be started as early as possible. Gastric mucosal protective agents can improve the curative effect and can be selected according to the condition of patients with obvious adverse reactions. Our study provided evidence for their potential clinical use in the management of CAG. However, CAG-related studies in other countries and regions need to be further studied. Registration The logn number of our Meta-analysis on PROSPERO is 42,024,571,785.
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spelling doaj-art-212eb4feef28445cbfce0c5a43b4f5a72025-02-09T12:39:38ZengBMCBMC Gastroenterology1471-230X2025-02-0125111410.1186/s12876-025-03644-1Efficacy analysis of folic acid in chronic atrophic gastritis with Helicobacter pylori infection: a systematic review and meta-analysisHui Li0Jincheng Li1Mingyu Lai2Department of Gastroenterology, The First Affiliated Hospital of Guangxi Medical UniversityDepartment of Gastroenterology, The First Affiliated Hospital of Guangxi Medical UniversityDepartment of Gastroenterology, The First Affiliated Hospital of Guangxi Medical UniversityAbstract Background Current data indicate that supplements such as folic acid play a significant role in treating chronic atrophic gastritis (CAG). However, no meta-analysis article evaluates its efficacy comprehensively. Therefore, we conducted a meta-analysis to compare the effectiveness and safety of folic acid in the treatment of CAG with Helicobacter pylori (H. pylori) infection. Methods Using a systematic review method, consider randomized controlled trials (RCT), including clinical trial reports, unpublished clinical trial data, and conference papers. A comprehensive search of the literature was conducted from all years up to June 2024. We searched PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Vip, and Wanfang databases. Data were extracted using a pre-designed extraction tool and analysis was undertaken using RevMan5.4 and STAT15.1. Efficacy and safety outcomes were evaluated using risk ratio (RR) and 95% confidence intervals (CI). Results 16 randomized controlled trials with 1364 patients were included. Compared with conventional therapy, folic acid therapy had a higher total effective rate (95.09% vs.79.06%, pooled RR = 1.19, 95% CI: 1.12–1.26, p < 0.00001) and lower incidence of adverse events (11.64% vs. 14.04%, RR = 0.86, 95% CI: 0.46–1.60, p = 0.64). Moreover, folic acid can better improve gastric function and repair gastric mucosa (MD = 27.20, 95%CI:23.84–30.56, p < 0.00001). Conclusions For HP-related CAG, anti-HP treatment and folic acid supplementation should be started as early as possible. Gastric mucosal protective agents can improve the curative effect and can be selected according to the condition of patients with obvious adverse reactions. Our study provided evidence for their potential clinical use in the management of CAG. However, CAG-related studies in other countries and regions need to be further studied. Registration The logn number of our Meta-analysis on PROSPERO is 42,024,571,785.https://doi.org/10.1186/s12876-025-03644-1Chronic atrophic gastritisFolic acidHelicobacter pyloriEffective rateAdverse eventsMeta-analysis
spellingShingle Hui Li
Jincheng Li
Mingyu Lai
Efficacy analysis of folic acid in chronic atrophic gastritis with Helicobacter pylori infection: a systematic review and meta-analysis
BMC Gastroenterology
Chronic atrophic gastritis
Folic acid
Helicobacter pylori
Effective rate
Adverse events
Meta-analysis
title Efficacy analysis of folic acid in chronic atrophic gastritis with Helicobacter pylori infection: a systematic review and meta-analysis
title_full Efficacy analysis of folic acid in chronic atrophic gastritis with Helicobacter pylori infection: a systematic review and meta-analysis
title_fullStr Efficacy analysis of folic acid in chronic atrophic gastritis with Helicobacter pylori infection: a systematic review and meta-analysis
title_full_unstemmed Efficacy analysis of folic acid in chronic atrophic gastritis with Helicobacter pylori infection: a systematic review and meta-analysis
title_short Efficacy analysis of folic acid in chronic atrophic gastritis with Helicobacter pylori infection: a systematic review and meta-analysis
title_sort efficacy analysis of folic acid in chronic atrophic gastritis with helicobacter pylori infection a systematic review and meta analysis
topic Chronic atrophic gastritis
Folic acid
Helicobacter pylori
Effective rate
Adverse events
Meta-analysis
url https://doi.org/10.1186/s12876-025-03644-1
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AT mingyulai efficacyanalysisoffolicacidinchronicatrophicgastritiswithhelicobacterpyloriinfectionasystematicreviewandmetaanalysis