10-Day versus 14-day bismuth quadruple therapy for first-line eradication of Helicobacter pylori infection: a randomised, open-label, non-inferiority trial

Yang, Er-Hsiang; Chen, Wei-Ying; Chiang, Hsueh-Chien; Li, Chung-Hao; Wu, I-Hsuan; Chen, Po-Jun; Wu, Chung-Tai; Tsai, Yu-Ching; Cheng, Wei-Chun; Huang, Chien-Jui; Sheu, Bor-Shyang; Cheng, Hsiu-Chi

doi:10.1016/j.eclinm.2024.102529

Cited by 2 publications

(1 citation statement)

References 28 publications

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“…Guidelines suggest a prolonged regimen. Despite recent advancements, however, the clear superiority of prolonging the duration to 14 days has not been demonstrated [35]. A small increase in therapy success certainly is often counterbalanced by more common adverse effects.…”

Section: Discussionmentioning

confidence: 99%

Concomitant and Bismuth Quadruple Therapy for Helicobacter pylori Eradication in Southern Italy: Preliminary Data from a Randomized Clinical Trial

Losurdo,

Borraccino,

Aloisio

et al. 2024

Antibiotics

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Concomitant therapy (CT) and bismuth quadruple therapy (BQT) are recommended in geographical areas with high clarithromycin resistance for Helicobacter pylori (H. pylori) eradication. We compared CT and BQT as the first lines of treatment in a randomized controlled trial. Consecutive patients with H. pylori diagnosed by concordance of both a urea breath test and histology were recruited. For BQT, patients received 3 PyleraTM capsules q.i.d.; for CT, 1000 mg of amoxicillin b.i.d, 500 mg of clarithromycin b.i.d and 500 mg of metronidazole b.i.d. As a proton pump inhibitor, 40 mg of pantoprazole b.i.d was administered. Both regimens lasted 10 days. In total, 46 patients received CT and 38 BQT. Both groups were comparable for age (p = 0.27) and sex (p = 0.36). We did not record any drop outs; therefore, the intention to treat and per protocol rates coincided. The most common symptoms were heartburn and post-prandial fullness, which were equally present in both groups. The success rate was 95.6% for CT and 100% for BQT (p = 0.56). Side effects were recorded in 23.9% and 31.6% of patients in the CT and BQT arms, respectively (p = 0.47). The most common ones were abdominal pain (8) and diarrhea (6). In conclusion, CT and BQT are equally effective in our area with high clarithromycin resistance, southern Italy, and showed comparable safety.

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Section: Discussionmentioning

confidence: 99%

Concomitant and Bismuth Quadruple Therapy for Helicobacter pylori Eradication in Southern Italy: Preliminary Data from a Randomized Clinical Trial

Losurdo,

Borraccino,

Aloisio

et al. 2024

Antibiotics

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Efficacy and safety of 10-day versus 14-day bismuth-containing quadruple therapy for H. pylori eradication: A systematic review and meta-analysis

Gohar,

Ejaz,

Ahmed

et al. 2024

Preprint

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BackgroundNearly half of the world population is infected byHelicobacter pylori (H. pylori).Bismuth-containing quadruple therapy (BQT) has shown favorable outcomes. This study compares 10-day and 14-day BQT regimens to evaluate their efficacy, safety, and compliance rates.MethodsWe searched electronic databases from their inception until May 2024 to retrieve all randomized controlled trials (RCTs) that compared 10-day and 14-day BQT regimens forH. pylorieradication. Meta-analysis was performed using Review Manager 5.4. Dichotomous outcomes were compared using risk ratio (RR).ResultsSeven RCTs and a total of 2,424 patients were included in the meta-analysis. There was no significant difference in the intention-to-treat eradication rate (RR 0.97; 95% CI 0.94, 1.01) and the per-protocol eradication rate (RR 0.96; 95% CI 0.93, 1.00) between the 10-day BQT and 14-day BQT groups. Commonly reported adverse events in both groups were epigastric pain and discomfort, nausea, and vomiting. There was no significant difference in the risk of adverse events between the two groups (RR 0.80; 95% CI 0.63, 1.02). There was no significant difference in the compliance rate between the two groups (RR 1.02; 95% CI 1.00, 1.04).ConclusionThe eradication rates, risk of adverse events, and compliance rates were comparable between the two groups. Future research comparing similar drug doses with larger sample sizes and longer patient follow-ups can improve the quality of results.HighlightsOur meta-analysis comprising 2424 patients showed that patients receiving 10-day bismuth-containing quadruple therapy had comparable eradication rates to those receiving 14-day bismuth-containing quadruple therapy forHelicobacter pylori.Additionally, there was no significant difference between the two groups for compliance and risk of adverse events.Antibiotic resistance was associated with lower eradication rates in both treatment groups.

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10-Day versus 14-day bismuth quadruple therapy for first-line eradication of Helicobacter pylori infection: a randomised, open-label, non-inferiority trial

Cited by 2 publications

References 28 publications

Concomitant and Bismuth Quadruple Therapy for Helicobacter pylori Eradication in Southern Italy: Preliminary Data from a Randomized Clinical Trial

Concomitant and Bismuth Quadruple Therapy for Helicobacter pylori Eradication in Southern Italy: Preliminary Data from a Randomized Clinical Trial

Efficacy and safety of 10-day versus 14-day bismuth-containing quadruple therapy for H. pylori eradication: A systematic review and meta-analysis

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