Hybrid Therapy Regimen for Helicobacter Pylori Eradication

Song, Zhiqiang; Liu, Jian; Zhou, Liya

doi:10.4103/0366-6999.179803

Cited by 12 publications

(14 citation statements)

References 33 publications

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“…In one review article, a total of 1871 patients in 12 studies received hybrid therapy[ 26 ]. The eradication rate of H. pylori was 82.6%-99.1%, and pooled analysis showed the eradication rate was 91.2% in per-protocol analyses.…”

Section: Discussionmentioning

confidence: 99%

CYP2C19 polymorphism has no influence on rabeprazole-based hybrid therapy forHelicobacter pylorieradication

Lin

Lee

Wang

et al. 2018

WJCC

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AIMTo evaluate the impact of cytochrome P450 2C19 (CYP2C19) and interleukin-1β (IL-1β) polymorphisms on the efficacy of Helicobacter pylori (H. pylori) eradication by using rabeprazole-based hybrid therapy.METHODSA total of 88 H. pylori-infected patients were recruited to receive 14-d of hybrid therapy from March 2013 to May 2014. Three patients were excluded from analysis because of incomplete compliance. Either a follow-up endoscopy or 13C-urea test was performed to determine the results of H. pylori eradication therapy. The genotypes of CYP2C19 and IL-1β were analyzed to investigate the impact on treatment effect.RESULTSThe total eradication rate of H. pylori was 92.94% (79/85). According to the CYP2C19 genotypes, the rates of H. pylori eradication were 89.19% in extensive metabolizers (EM) and 95.83% in non-EM. The H. pylori eradication rates regarding the IL-1β genotypes were 92.59% in the normal acid secretion group and 93.10% in the low acid secretion group. After multivariable logistic regression analysis, both the genotypes of CYP2C19 and IL-1β had no significant influences on the eradication rates of H. pylori.CONCLUSIONThe CYP2C19 and IL-1β polymorphisms are not significantly independent factors of H. pylori eradication using rabeprazole-based hybrid therapy.

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Section: Discussionmentioning

confidence: 99%

CYP2C19 polymorphism has no influence on rabeprazole-based hybrid therapy forHelicobacter pylorieradication

Lin

Lee

Wang

et al. 2018

WJCC

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“…Hybrid regimens are another type that proved their efficacy in a recent meta-analysis [143]. In 2 recently published Greek studies, an over 90% eradication rate in per-protocol analysis was proved [129,142].…”

Section: Recommendation Grade: A; Evidence Level: 1b; Agreement Levelmentioning

confidence: 99%

Hellenic consensus on Helicobacter pylori infection

Georgopoulos

Michopoulos

Rokkas³

et al. 2020

aog

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The Hellenic Society of Gastroenterology recently organized the "Hellenic consensus on Helicobacter pylori (H. pylori) infection". The aim of this publication is to report the guidelines in order to aid the national gastroenterology community in the management of H. pylori infection. Forty-one delegates from all Greek regions, including gastroenterologists, pathologists, clinical microbiologists, epidemiologists and basic scientists, were invited to this meeting. The participants were allocated to 1 of the 4 main topics of the meeting: i.e., H. pylori diagnosis and association with diseases; H. pylori and gastric cancer; H. pylori and extragastric associated disorders; and H. pylori treatment. The results of each subgroup were submitted to a final consensus vote that included all participants. Relevant data based on international and Greek publications were presented, and the quality of evidence, strength of recommendation, and level of consensus were graded. The cutoff level of 70% was considered as acceptance for the final statement. It is hoped that the recommendations and conclusions of this report will guide Greek doctors in their daily practice concerning the management of H. pylori infection.

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“…A prospective study this year of hybrid therapy as a first‐line regimen was disappointing, revealing an eradication rate of 77% . A systematic review published this year reported 77%‐97% eradication with hybrid therapy and excellent compliance with low adverse event rates …”

Section: Sequential Concomitant and Hybrid Therapymentioning

confidence: 99%

“…33 A systematic review published this year reported 77%-97% eradication with hybrid therapy and excellent compliance with low adverse event rates. 34 A head-to-head trial of hybrid vs concomitant therapy was carried out in Iran which demonstrated eradication rates of 87.3% for hybrid therapy compared to 80.9% for sequential. 35 One systematic review of 12 trials comparing sequential, concomitant and hybrid therapies showed no significant difference in eradication rates between the treatments with similarly high compliance rates and acceptable adverse event rates.…”

Section: Sequential Concomitant and Hybrid Therapymentioning

confidence: 99%

Treatment of Helicobacter pylori infection 2017

et al. 2017

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Over the last decade, it has been widely reported that the success of Helicobacter pylori eradication treatment is falling. A steady decline was observed in the number of patients achieving eradication with standard first-line triple therapy of two antibiotics and a proton pump inhibitor [1][2][3]. It now appears that the first-line eradication therapies most commonly used in everyday clinical practice fall considerably short of the 80% intention-to-treat (ITT) eradication rates that are considered the minimal acceptable levels as recommended in the Maastricht guidelines [4]. Interestingly, two studies emerged from Asian centers in the last 12 months, which show that, in this part of the world at least, eradication levels using standard therapies remain close to 80%. A Malaysian study showed a standard 1-week pantoprazole, amoxycillin, and clarithromycin regimen to be well tolerated and highly efficacious with a per-protocol eradication rate of 84% [5]. A Japanese study showed remarkably consistent per-protocol eradication rates from 2001 to 2009 fluctuating between 75 and 78% for standard 7-day triple-therapy regimens [6]. A limit of many studies especially those including clarithromycin or levofloxacin is that H. pylori susceptibility to the drugs, which is the main prediction of failure, was not tested. LevofloxacinThe use of levofloxacin as a first-line therapy has been examined in great depth in the last year. Levofloxacin may be used as a substitute for clarithromycin in either a standard triple or sequential regimen. A large study comparing the antibiotics in either regimen shows a clear advantage to levofloxacin in both combinations. Per-protocol cure rates for triple therapy were 66% for omeprazole-clarithromycin-amoxycillin compared with 83% for omeprazole-levofloxacin-amoxycillin and 81% for omeprazole-amoxycillin-clarithromycin-metronidazole vs 85% for omeprazole-amoxycillin-levofloxacinmetronidazole, with no difference in compliance rates or adverse events [7]. It has been proposed that sequential levofloxacin-based regimens are of most benefit in areas where clarithromycin resistance is in excess of 15%, and another study in such an area showed eradication rates of 81% with clarithromycin sequential therapy compared with 96% with levofloxacin sequential therapy. A third arm in this study looked at the dose of levofloxacin required and illustrated no benefit in increasing the dose from 250 to 500 mg [8]. Indeed, another study went so far as to suggest that once-daily dosing of a levofloxacin-based triple regimen may be as efficacious as twice daily [9]. The literature from Asia also seems to support levofloxacin as a good alternative first-line therapy. A study on a triple regimen showed per-protocol eradication rates of 78% for standard clarithromycin-containing therapies compared with 83% for a levofloxacin-based regimen [10]. Another study from the Middle East looked at whether combining clarithromycin and levofloxacin in the same regimen could be Keywords Peptic ulcer disease, resistance, compli...

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Hybrid Therapy Regimen for Helicobacter Pylori Eradication

Cited by 12 publications

References 33 publications

CYP2C19 polymorphism has no influence on rabeprazole-based hybrid therapy forHelicobacter pylorieradication

CYP2C19 polymorphism has no influence on rabeprazole-based hybrid therapy forHelicobacter pylorieradication

Hellenic consensus on Helicobacter pylori infection

Treatment of Helicobacter pylori infection 2017

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