A multicenter, randomized, prospective study of 14-day ranitidine bismuth citrate- vs. lansoprazolebased triple therapy for the eradication of Helicobacter pylori in dyspeptic patients

Avşar, Erol; Tıftıkcı, Arzu; Poturoğlu, Şule; Erzın, Yusuf; Kocakaya, Ozan; Dinçer, Dinç; Yıldırım, Bulut; Güliter, Sefa; Türkay, Cansel; Yılmaz, Uğur; Onuk, Mehmet Derya; Bolukbas, Cengiz; Ellidokuz, Ender; Bektaş, Ahmet; Taşan, Güralp; Aytuğ, Necip; Ateş, Yüksel; Kaymakoğlu, Sabahattin

doi:10.4318/tjg.2013.0509

Cited by 8 publications

(12 citation statements)

References 20 publications

(18 reference statements)

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“…Overall, 2189 studies were reviewed in the literature search. The selection criteria were applied as previously described, and a total of 25 studies were eligible for the final analysis (Figure ) . All enrolled studies were limited to randomized control trials, and a 3990 patients infected with H.pylori were enrolled (Table ).…”

Section: Resultsmentioning

confidence: 99%

“…There were 15 trials describing the number of patients who had side effects . In the ITT analysis, the rates of adverse events in bismuth‐containing and non‐bismuth regimens were 28.8% and 26.5%, respectively.…”

Section: Resultsmentioning

confidence: 99%

“…Among them, a bismuth-containing regimen was prescribed in 2003 patients, whereas the remaining 1987 patients received a non-bismuth regimen. There were 18 trials [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] that were defined as "bismuth substitution," and the remaining seven trials 1-7 were "bismuth add-on." In six trials 14,16,20,24,26,29 with a study design of multiple arms, only the data of the groups that met the inclusion criteria were extracted and included for analysis.…”

Section: Study Selectionmentioning

confidence: 99%

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Bismuth supplements as the first‐line regimen for Helicobacter pylori eradication therapy: Systemic review and meta‐analysis

Kim

Chung

et al. 2019

Helicobacter

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Background and Aims An increase in the use of antibiotics leads to increased antibiotic resistance of Helicobacter pylori (H pylori). Consequently, it has been considered that the first‐line standard regimen should be changed. The main purpose of this study was to evaluate the efficacy of nonantibiotic (bismuth) supplements as a first‐line regimen for H pylori eradication. Methods We searched PubMed, EMBASE, CINAHL, and the Cochrane Library databases for randomized controlled trials (RCTs) reported in English and undertaken up until August 2018. A meta‐analysis of all randomized controlled trials comparing bismuth supplements with non‐bismuth‐containing regimens in H pylori eradication was performed. RCTs of classic bismuth‐containing quadruple therapy as a first‐line regimen were excluded. Results We identified twenty‐five randomized trials (3990 patients), and the total H pylori eradication rate, according to per protocol analyzed, was 85.8%. The odds ratio was 1.83 (95% confidence interval (CI). 1.57‐2.13). Among these RCTs, there were 7 RCTs for bismuth add‐on therapy, and the odds ratio was 2.81 (95% CI. 2.03‐3.89). When the studies were performed in a high clarithromycin resistance area (≥15%) or included patients with clarithromycin resistance, bismuth‐containing regimens were superior to non‐bismuth regimens. Moreover, the incidence of total side effects was insignificant. Conclusions Bismuth supplements as a first‐line regimen could be effective, with bismuth add‐on regimens being the most effective. Particularly, bismuth supplements showed the potential efficacy for clarithromycin‐resistant strains and would be the most viable alternative in clinical practice.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Study Selectionmentioning

confidence: 99%

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Bismuth supplements as the first‐line regimen for Helicobacter pylori eradication therapy: Systemic review and meta‐analysis

Kim

Chung

et al. 2019

Helicobacter

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“…The first found an eradication rate of 90.7% when bismuth was used with PPI, amoxicillin, and clarithromycin . The second study looked at the use of ranitidine bismuth citrate as an alternative to PPI and found it to be as effective, but in this case, eradication rates were poor in both arms (65.1% for ranitidine bismuth citrate users and 63.6% for PPI users) . Two further studies looked at the role of bismuth in second‐line therapy.…”

Section: Bismuth‐based Therapiesmentioning

confidence: 99%

Treatment of Helicobacter pylori Infection 2014

et al. 2014

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This review summarizes important studies regarding H.pylori therapy published from April 2013 to April 2014. The main themes that emerge are assessing the efficacy of standard triple therapy, as well as exploring new first-line treatments, predominantly optimized triple therapies and non-bismuth quadruple schemes. Regarding newer non-bismuth quadruple regimens, the compliance and tolerance seem to be similar for sequential and concomitant regimens. Notably, no study yet has demonstrated a clear statistical superiority for either, and a systematic review and meta-analysis may be warranted. Other studies examined the role of levofloxacin and bismuth based therapies in H. pylori eradication. The efficacy of bismuth as a second-line after sequential therapy was particularly noteworthy. Levofloxacin-based therapies also appear to be useful and versatile as part of different antibiotic combinations and in first-, second-, and third-line therapies. The emerging problem of quinolone resistance remains a worry. Individualized therapy, based on factors such as antimicrobial information, resistance data, and CYP2C19 metabolism, may well be the most notable future trend to emerge this year.

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“…H. pylori infection is endemic in Turkey, and 82.5% of the population is infected mainly before the age of 20 (20). Furthermore, due to high antibiotic resistance rates, failure of H. pylori eradication is frequent (21,22). Therefore, H. pylori is a pivotal factor in determining strategies against GC.…”

Section: Surveillance Of Patients With Precancerous Conditions For Dementioning

confidence: 99%

Gastric cancer prevention from the point of helicobacter

Balaban

Şimşek²,

Tatar³

2014

Turk J Gastroenterol

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When the first cancer estimates of world were made in 1975, gastric cancer (GC) was the most common neoplasm, making 70% of the total. Although its rate decreased to 6.8% in 2012, it is still the fifth most common malignancy after cancers of the lung, breast, colo-rectum, and prostate and the third leading cause of cancer death in both sexes worldwide (8.8%, 723,000 deaths) (1). Proximal (cardia) and distal (non-cardia) gastric adenocarcinomas have different epidemiological and clinical features. Although there is an increase in proximal GCs, most of the GCs are still distally located, and intestinal-type. H. pylori is an established trigger of gastric carcinogenesis; reversibility of precancerous conditions, including intestinal metaplasia (IM), after eradication treatment is a hot topic for research. Therefore, we read with great interest the study by Galiatsatos P et al. (2) on the sensitivity of gastric biopsy for H. pylori detection in the presence of IM. The data have once again emphasized the importance of using non-invasive tests and histopathology together in the presence of gastric IM.

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A multicenter, randomized, prospective study of 14-day ranitidine bismuth citrate- vs. lansoprazolebased triple therapy for the eradication of Helicobacter pylori in dyspeptic patients

Cited by 8 publications

References 20 publications

Bismuth supplements as the first‐line regimen for Helicobacter pylori eradication therapy: Systemic review and meta‐analysis

Bismuth supplements as the first‐line regimen for Helicobacter pylori eradication therapy: Systemic review and meta‐analysis

Treatment of Helicobacter pylori Infection 2014

Gastric cancer prevention from the point of helicobacter

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