Reviewer ’s report  
 
Title: Pharmacological regimens for eradication of Heli cobacter pylori: an overview of 
systematic  reviews and network meta -analysis  
 
Version: 0 Date: 22 Feb 2016  
 
Reviewer: Mitsushige Sugimoto  
 
Reviewer's report:  
 
General:  
Authors investigated efficacy of eradication therapy for the eradication of H. pylori in systematic 
reviews. Of 24 systematic reviews, the esomeprazole -based triple therapy had the most effective 
outco me, followed by rabeprazole, while no difference was observed among the three old 
generations of PPI in the eradication of H. pylori, pantoprazole, omeprazole and lansoprazole. In 
addition, when comparing triple and bismuth based therapy, the relative effe ctiveness appeared 
to be dependent on the choice of antibiotics within the triple therapy. Authors suggested that the 
new generation of PPIs and use of moxifloxacin or levofloxacin were associated with outcome 
and recommends that this point should be incor porated into the considerations when updating the 
clinical guidelines in the future.  
 
 
 
Major comments:  
 
1. In general, eradication rate depends on infection of resistant strain to antimicrobial agent, 
treatment period, kinds of PPI and antimicrobial agent an d CYP2C19 genotype. In this 
study, although authors compared efficacy among different PPIs, kinds of antimicrobial 
agents in each study differed. Therefore, it may be hard to compare efficacy among 
different PPIs.  
 
 
2. In addition, eradication rate differed  among different location and/or population. Authors 
should reanalyze and add comments.  
 
 
3. If possible, it will be better to add resistant rate to antimicrobial agent in Tables.  
 
 
4. Authors should clarify differences from previous several systematic revie ws. 
 
 
 
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the autho rs. 
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an a dditional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, conside ring the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  
If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wis h to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: Pharmacological regimens for eradication of Heli cobacter pylori: an overview of 
systematic  reviews and network meta -analysis  
 
Version: 0 Date: 22 Feb 2016  
 
Reviewer: Mitsushige Sugimoto  
 
Reviewer's report:  
 
General:  
Authors investigated efficacy of eradication therapy for the eradication of H. pylori in systematic 
reviews. Of 24 systematic reviews, the esomeprazole -based triple therapy had the most effective 
outco me, followed by rabeprazole, while no difference was observed among the three old 
generations of PPI in the eradication of H. pylori, pantoprazole, omeprazole and lansoprazole. In 
addition, when comparing triple and bismuth based therapy, the relative effe ctiveness appeared 
to be dependent on the choice of antibiotics within the triple therapy. Authors suggested that the 
new generation of PPIs and use of moxifloxacin or levofloxacin were associated with outcome 
and recommends that this point should be incor porated into the considerations when updating the 
clinical guidelines in the future.  
 
 
 
Major comments:  
 
1. In general, eradication rate depends on infection of resistant strain to antimicrobial agent, 
treatment period, kinds of PPI and antimicrobial agent an d CYP2C19 genotype. In this 
study, although authors compared efficacy among different PPIs, kinds of antimicrobial 
agents in each study differed. Therefore, it may be hard to compare efficacy among 
different PPIs.  
 
 
2. In addition, eradication rate differed  among different location and/or population. Authors 
should reanalyze and add comments.  
 
 
3. If possible, it will be better to add resistant rate to antimicrobial agent in Tables.  
 
 
4. Authors should clarify differences from previous several systematic revie ws. 
 
 
 
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the autho rs. 
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an a dditional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, conside ring the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  
If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wis h to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title: Pharmacological regimens for eradication of Heli cobacter pylori: an overview of 
systematic  reviews and network meta -analysis  
 
Version: 0 Date: 22 Feb 2016  
 
Reviewer: Mitsushige Sugimoto  
 
Reviewer's report:  
 
General:  
Authors investigated efficacy of eradication therapy for the eradication of H. pylori in systematic 
reviews. Of 24 systematic reviews, the esomeprazole -based triple therapy had the most effective 
outco me, followed by rabeprazole, while no difference was observed among the three old 
generations of PPI in the eradication of H. pylori, pantoprazole, omeprazole and lansoprazole. In 
addition, when comparing triple and bismuth based therapy, the relative effe ctiveness appeared 
to be dependent on the choice of antibiotics within the triple therapy. Authors suggested that the 
new generation of PPIs and use of moxifloxacin or levofloxacin were associated with outcome 
and recommends that this point should be incor porated into the considerations when updating the 
clinical guidelines in the future.  
 
 
 
Major comments:  
 
1. In general, eradication rate depends on infection of resistant strain to antimicrobial agent, 
treatment period, kinds of PPI and antimicrobial agent an d CYP2C19 genotype. In this 
study, although authors compared efficacy among different PPIs, kinds of antimicrobial 
agents in each study differed. Therefore, it may be hard to compare efficacy among 
different PPIs.  
 
 
2. In addition, eradication rate differed  among different location and/or population. Authors 
should reanalyze and add comments.  
 
 
3. If possible, it will be better to add resistant rate to antimicrobial agent in Tables.  
 
 
4. Authors should clarify differences from previous several systematic revie ws. 
 
 
 
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the autho rs. 
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an a dditional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, conside ring the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  
If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wis h to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant