Comparison of 10 and 14 days of triple therapy versus 10 days of sequential therapy for Helicobacter pylori eradication: A prospective randomized study

Ennkaa, Abulgasim; Shaath, Nabeel M; Salam, Abdul; Mohammad, Ramzi M.

doi:10.5152/tjg.2018.17707

Cited by 8 publications

(15 citation statements)

References 26 publications

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“…The average presenting age in our study was 40.0±24.4 years. This was similar to a local study in Lahore with 40.51±13.04 years and an international study in Qatar with 38.85±11.78 years [ 11 , 15 ]. Male predominance was seen in our study, which is consistent with a local study [ 16 ].…”

Section: Discussionsupporting

confidence: 90%

“…Despite a large number of studies, the single best therapeutic regimen for the treatment of H. pylori could not be established. In trials, sequential therapy has shown higher eradication rates than standard triple therapy [ 11 , 12 ]. However, management guidelines differ among countries and depend on local susceptibility patterns [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

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Randomized Clinical Trial on the Efficacy of Triple Therapy Versus Sequential Therapy in Helicobacter pylori Eradication

Sharif¹,

Mubashir²,

Naqvi³

et al. 2022

Cureus

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Introduction: Helicobacter pylori ( H. pylori ) colonization is prevalent all over the world, and it is associated with low socioeconomic status, poor hygiene, and overcrowding. Its eradication is important since it is an etiologic agent for gastritis, peptic ulcer, gastric carcinoma, and mucosa-associated lymphoid tissue lymphoma. Different regimens are available for the eradication of H. pylori and include triple therapy and sequential therapy. Our study aims to compare the efficacy of triple therapy versus sequential therapy in the eradication of H. pylori . Material and methods: This randomized clinical trial was conducted at the Pakistan Institute of Medical Sciences Hospital, Islamabad, from September 2016 to September 2017 after the approval of the institutional review board. A total of 160 patients were enrolled and equally divided into two, group A and group B. A twice-daily dose of amoxicillin 1,000 mg, rabeprazole 20 mg, and clarithromycin 500 mg was given to group A for 10 days, while group B was initially given rabeprazole 20 mg and amoxicillin 1,000 mg two times daily for the first five days (i.e., induction phase), followed by triple therapy that included rabeprazole 20 mg, clarithromycin 500 mg, and metronidazole/tinidazole 500 mg twice daily for the next five days. A negative stool antigen test performed four weeks after the completion of therapy was considered an effective eradication. A proforma was used to collect data that included age, gender, city or province of residence, family income, group (group A or group B), and eradication efficacy. Analysis of the data was performed using the Statistical Package for the Social Sciences version 17 (SPSS Inc., Chicago, USA). Results: A total of 160 patients were included, with mean age and standard deviation of 40.02±24.4 years. The male/female ratio was 1.8:1. Successful eradication of H. pylori achieved in group A was 67.5% (N=54) in comparison to group B, which was 95% (N=76) (p=0.001). Conclusion: Sequential therapy was superior to triple therapy in H. pylori eradication.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Randomized Clinical Trial on the Efficacy of Triple Therapy Versus Sequential Therapy in Helicobacter pylori Eradication

Sharif¹,

Mubashir²,

Naqvi³

et al. 2022

Cureus

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“…Thus, the findings of this study present for the first time the cost-effectiveness of two commonly utilized H. pylori treatment regimens in Saudi Arabia. [ 15 16 17 18 ] The 10-day SQT was found to be more cost-effective than the 14-day STT with more than 50% level of confidence using probabilistic sensitivity analysis with 10,000 replications, that varied both H. pylori eradication rates, drug acquisition costs, and diagnostic procedures. These findings are consistent with previously published studies that showed SQT to be more cost-effective in eradicating H. pylori .…”

Section: Discussionmentioning

confidence: 99%

“…However, this difference in eradication rates between SQT and STT did not reach a statistically significant level in both intention to treat (ITT) and per protocol (PP) analyses. [ 15 ] Furthermore, in another single-center, randomized open-label trial that examined the efficacy of SQT versus STT in eradicating H. pylori in Saudi Arabia, the ITT eradication rates or treatment success rates as confirmed by the negative urea breath test (UBT) were 50.4% and 59% for SQT and STT, respectively; and, the PP eradication rates were 62.4% and 67.6% for SQT and STT, respectively. However, neither ITT nor PP eradication rates were significantly different between the two treatment regimens (i.e., SQT and STT).…”

Section: Introductionmentioning

confidence: 99%

The cost-effectiveness of sequential versus standard triple therapy for Helicobacter pylori eradication in Saudi Arabia

AlRuthia

Almadi

Alqahtani

et al. 2021

Saudi J Gastroenterol

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Background: The utilization rate of different treatment regimens for Helicobacter pylori infection is believed to be high; however, the cost-effectiveness of these regimens has not been examined before. Therefore, the aim of this study was to examine the cost-effectiveness of the two commonly prescribed treatments for H. pylori infection. Methods: The data of an open-label, single-center, randomized trial that compared the efficacy of sequential therapy (SQT) (i.e., esomeprazole 20 mg twice daily for 10 days, amoxicillin 1000 mg twice daily for 5 days, then clarithromycin 500 mg and tinidazole 500 mg twice daily for 5 days) to standard triple therapy (STT) (i.e., esomeprazole 20 mg, amoxicillin 1000 mg, and clarithromycin 500 twice daily for 14 days) in the eradication of H. pylori , as confirmed by the negative urea breath test (UBT), were used. Propensity score matching bin bootstrapping, with 10,000 replications and bias correction was conducted to generate the 95% confidence limits. Moreover, probabilistic sensitivity analysis was conducted by varying both the eradication rates and the costs of treatment regimens. Results: There were 82 and 88 patients who were on SQT and STT, respectively. Patients' mean age was 47 years, and approximately 55% of them were females. The mean treatment costs were SAR 2,075.51 (USD 553.47) and SAR 2,629.26 (USD 701.14) for SQT and STT, respectively. The mean eradication rates for SQT and STT were 63.41% and 67.05%, respectively. The mean difference in costs and eradication rates for SQT versus STT were SAR − 550.75 (95% CI: −563.84- −537.69) and − 3.64% (95% CI: −6.98- 5.88). The use of SQT was more likely to be cost saving and more effective with 56.25% confidence level, in comparison to STT. Conclusion: The use of SQT in the treatment of H. pylori seems to be more cost-effective than STT.

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“…Our sample consisted of a total of 7,829 patients, including both genders aged between 2 and 75 years. Studies from Egypt (n=18) [28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45] , Saudi Arabia (n=8) [46][47][48][49][50][51][52][53] , Lebanon (n=6) [54][55][56][57][58][59] , UAE (n=5) [60][61][62][63][64] , Iraq (n=3) [65][66][67] , Qatar (n=3) [68][69][70] , Algeria (n=2) 71,72 , Palestine (n=1) 73 , Morocco (n=1) 74 , Syria (n=1) 75 , Yemen (n=1) 76 Tunisia (n=1) 77…”

Section: Patients and Study Characteristicsmentioning

confidence: 99%

Treatment of Helicobacter pylori in the Arab world: a systematic review and network meta-analysis

Afify

Abd-ElGawad

Bahbah

et al. 2021

Preprint

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Purpose: We aimed to conduct an updated systematic review and network meta-analysis (NMA) to estimate the efficacy of Helicobacter pylori (H. pylori) treatment strategies in Arab countries. Methods: We systematically searched PubMed, Scopus, Web of Science (WOS), EBSCO, and EMBASE from inception to July 18, 2020, using boolean operators. Retrieved articles were screened, and relevant data were extracted. We used R programming software to analyze extracted data. Results: Fifty-four articles (n= 7829 patients) were included in the NMA. Pooled overall analysis demonstrated that adjuvant therapy (standard triple or sequential therapy plus another adjuvant drug) was the best treatment with higher odds of eradication rate [OR= 6.42, 95% CI (1.37: 30.05), P-score= 0.21]. Moreover, Seqential therapy (SQT) and Quinolone based therapy (QBT) were associated with higher eradication rate compared to other regimens [OR= 4.83, 95% CI (1.49: 15.64), P-score= 0.30] and [OR= 4.32, 95% CI (1.15: 16.16), P-score= 0.36], respectively. In adults, the efficacy of QBT was higher than other stratigies in terms of H. pylori eradication [OR= 2.00, 95% CI (1.09, 3.69), P score= 0.19]. In naïve population, QBT and SQT were associated with substantial eradication rate [OR= 1.94, 95% CI (1.19: 3.16), P score=0.19] and [OR= 1.66, 95% CI (1.10: 2.50), P score=0.33], respectively. Conclusion: Our findings suggest that standard triple or sequential therapy plus another adjuvant drug, QBT and SQT therapies were the most effective regimens for eradicating H.pylori in Arab countries.

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Comparison of 10 and 14 days of triple therapy versus 10 days of sequential therapy for Helicobacter pylori eradication: A prospective randomized study

Abstract: Neither 10 d of ST nor 14 d of TT achieved the optimum H. pylori eradication rate.

Cited by 8 publications

References 26 publications

Randomized Clinical Trial on the Efficacy of Triple Therapy Versus Sequential Therapy in Helicobacter pylori Eradication

Randomized Clinical Trial on the Efficacy of Triple Therapy Versus Sequential Therapy in Helicobacter pylori Eradication

The cost-effectiveness of sequential versus standard triple therapy for Helicobacter pylori eradication in Saudi Arabia

Treatment of Helicobacter pylori in the Arab world: a systematic review and network meta-analysis

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