The effects of proton pump inhibitors (PPI) depend on metabolic enzyme that has different activity due to gene polymorphism. The purpose of this meta-analysis is to determine the potential effects of polymorphism on the efficiency of PPI-based treatment. The PubMed, EMBASE, Cochrane Library, etc. were searched for relevant articles published in English or Chinese from inception to 31 May 2020. Finally, 26 randomized controlled trials and 15 cohort studies met the inclusion criteria and used for the meta-analysis via STATA version 15. Poor metabolizer (PM) genotype eradication rates were highest for Asian individuals receiving triple or quadruple first-line therapy based on PPIs (p < 0.05). polymorphism could influence eradication rate only in Mainland China and Japan (p < 0.05). PM genotype facilitates the elimination of in Asian populations. Rabeprazole-, esomeprazole- and pantoprazole-based eradication program was less affected by the polymorphism.
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