Hybrid<i>vs</i>sequential therapy for eradication of<i>Helicobacter pylori</i>in Taiwan: A prospective randomized trial

Chen, Kuan-Yang; Lin, Tung-Yi; Lin, Chin-Lin; Lee, Hsi‐Chang; Wang, Chung-Kwe; Wu, Deng‐Chyang

doi:10.3748/wjg.v21.i36.10435

Cited by 28 publications

(47 citation statements)

References 36 publications

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“…In the “ H. pylori eradication” group, 92 patients had successful H. pylori eradication, while six patients still had positive UBT result 3 months later. The eradication rate was thus 93.9%, which was comparable with that in previous studies.…”

Section: Resultssupporting

confidence: 90%

Helicobacter pylori eradication improves glycemic control in type 2 diabetes patients with asymptomatic active Helicobacter pylori infection

Cheng

Yang

Hung

et al. 2019

J of Diabetes Invest

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Aims/Introduction Helicobacter pylori infection is associated with insulin resistance and glycemia in non‐diabetes. However, the relationship between H. pylori infection and glycemia in diabetes remains inconclusive. Therefore, we explored the effect of H. pylori infection status and its eradication on glycemic control and antidiabetic therapy in type 2 diabetes patients. Materials and Methods A total of 549 diabetes patients were recruited for sequential two‐step approach (immunoglobulin G [IgG] serology followed by 13 C‐urea breath test [UBT] ) to discriminate “active” (IgG+ and UBT +) from “non‐active” ( UBT − or IgG−) H. pylori infection, and “past” (IgG+ but UBT −) from “never/remote” (IgG−) infection. The differences in hemoglobin A1c (A1C) and antidiabetic regimens between groups were compared. In the “active” infection group, the differences in A1C changes between participants with and without 10‐day eradication therapy were compared after 3 months. Results Despite no between‐group difference in A1C, the “active” infection group ( n = 208) had significantly more prescriptions of oral antidiabetic drug classes (2.1 ± 1.1 vs 1.8 ± 1.1, P = 0.004) and higher percentages of sulfonylurea use (67.3% vs 50.4%, P < 0.001) than the “non‐active” infection group ( n = 341). There were no differences in A1C and oral antidiabetic drug classes between “past” ( n = 111) and “never/remote” infection groups ( n = 230). Compared with the non‐eradication group ( n = 99), the eradication group ( n = 98) had significant within‐group (−0.17 ± 0.80%, P = 0.036) and between‐group (−0.23 ± 0.10%, P = 0.024) improvements in A1C. Conclusions Diabetes patients with active H. pylori infection need higher glycemic treatment intensity to achieve comparable glycemia. Furthermore, H. pylori eradication decreases A1C, and thus improves glycemic control.

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Section: Resultssupporting

confidence: 90%

Helicobacter pylori eradication improves glycemic control in type 2 diabetes patients with asymptomatic active Helicobacter pylori infection

Cheng

Yang

Hung

et al. 2019

J of Diabetes Invest

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“…In other words, it is a 7-day first dual phase (PPI-amoxicillin) followed by a 7-day quadruple phase (PPI-amoxicillin-clarithromycin-nitroimidazole). Several metaanalyses including multiple RCTs with the hybrid treatment [122][123][124][125][126][127] have reported encouraging results with this regimen.…”

Section: Nonbismuth Hybrid Therapymentioning

confidence: 99%

Optimization strategies aimed to increase the efficacy of H. pylori eradication therapies

Gisbert

McNicholl

2017

Helicobacter

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Using potent acid inhibition and/or higher antibiotic doses-especially by increasing the number of daily intakes-and lengthening treatments up to 14 days improves efficacy in most regimens and should be generally recommended. Triple therapies can be efficiently improved by the addition of bismuth salts, turning them into quadruple therapies. Finally, some treatments will require a combination of optimization strategies to significantly improve results.

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“…The usual drug dosage was PPI standard dosage, amoxicillin 1 g, clarithromycin 0.5 g, and metronidazole/tinidazole 0.5 g all given twice daily. [ 4 6 7 ] Minor adjustments in hybrid regimen in some studies included increase in PPI dosage (double standard dosage)[ 6 8 9 10 11 12 ] and administration frequency of metronidazole (three times daily)[ 13 ] and decrease in administration time (3 days + 7 days,[ 12 ] 5 days + 7 days,[ 12 ] and 5 days + 5 days)[ 13 14 15 ] [ Table 1 ].…”

Section: Edication S Cheme and mentioning

confidence: 99%

Hybrid Therapy Regimen for Helicobacter Pylori Eradication

Song

Liu

Zhou

2016

Chinese Medical Journal

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Objective:Helicobacter pylori (H. pylori) eradication remains a challenge with increasing antibiotic resistance. Hybrid therapy has attracted widespread attention because of initial report with good efficacy and safety. However, many issues on hybrid therapy are still unclear such as the eradication efficacy, safety, compliance, influencing factors, correlation with antibiotic resistance, and comparison with other regimens. Therefore, a comprehensive review on the evidence of hybrid therapy for H. pylori infection was conducted.Data Sources:The data used in this review were mainly from PubMed articles published in English up to September 30, 2015, searching by the terms of “Helicobacter pylori” or “H. pylori”, and “hybrid”.Study Selection:Clinical research articles were selected mainly according to their level of relevance to this topic.Results:Totally, 1871 patients of 12 studies received hybrid therapy. The eradication rates were 77.6–97.4% in intention-to-treat and 82.6–99.1% in per-protocol analyses. Compliance was 93.3–100.0%, overall adverse effects rate was 14.5–67.5%, and discontinued medication rate due to adverse effects was 0–6.7%. H. pylori culture and sensitivity test were performed only in 13.3% patients. Pooled analysis showed that the eradication rates with dual clarithromycin and metronidazole susceptible, isolated metronidazole or clarithromycin resistance, and dual clarithromycin and metronidazole resistance were 98.5%, 97.6%, 92.9%, and 80.0%, respectively. Overall, the efficacy, compliance, and safety of hybrid therapy were similar with sequential or concomitant therapy. However, hybrid therapy might be superior to sequential therapy in Asians.Conclusions:Hybrid therapy showed wide differences in the efficacy but consistently good compliance and safety across different regions. Dual clarithromycin and metronidazole resistance were the key factor to efficacy. Hybrid therapy was similar to sequential or concomitant therapy in the efficacy, safety, and compliance.

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Hybridvssequential therapy for eradication ofHelicobacter pyloriin Taiwan: A prospective randomized trial

Abstract: Due to a grade A (> 95%) success rate for H. pylori eradication by PP analysis, similar compliance and adverse events, hybrid therapy seems to be an appropriate eradication regimen in Taiwan.

Cited by 28 publications

References 36 publications

Helicobacter pylori eradication improves glycemic control in type 2 diabetes patients with asymptomatic active Helicobacter pylori infection

Helicobacter pylori eradication improves glycemic control in type 2 diabetes patients with asymptomatic active Helicobacter pylori infection

Optimization strategies aimed to increase the efficacy of H. pylori eradication therapies

Hybrid Therapy Regimen for Helicobacter Pylori Eradication

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