Possibilities for optimization of eradication therapy for Helicobacter pylori infection in modern clinical practice

Andreev, D. N.; Дичева, Д. Т.; Маев, И. В.

doi:10.17116/terarkh201789284-90

Cited by 25 publications

(23 citation statements)

References 56 publications

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“…This is largely determined by the increase in the number of resistant strains of H. pylori in the population [11,37]. Given the lack of fundamentally new drugs for the treatment of H. pylori infection, it is important to optimize the existing eradication schemes [15,16]. The inclusion of rebamipide in eradication therapy regimens seems to be quite promising.…”

Section: Discussionmentioning

confidence: 99%

“…According to the latest meta-analyses, the effectiveness of one of the eradication schemes most commonly used in clinical practice—triple therapy—is at a relatively low level (approximately 69–77%) [12,13,14]. Given the lack of fundamentally new drugs for the treatment of H. pylori infection, it is important to optimize the existing eradication regimens [15,16]. In this regard, promising results were demonstrated when bismuth [17,18] or probiotics [19,20] were added to eradication regimens.…”

Section: Introductionmentioning

confidence: 99%

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Efficiency of the Inclusion of Rebamipide in the Eradication Therapy for Helicobacter pylori Infection: Meta-Analysis of Randomized Controlled Studies

Andreev

Маев

Дичева

2019

JCM

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Background: There has been a negative trend in the effectiveness of classic eradication therapy regimens for Helicobacter pylori (H. pylori), which has largely been determined from the emergence and spread of antibiotic resistance. Several studies have shown that adding rebamipide to eradication regimens leads to an increase in the effectiveness of treatment. Aim: To evaluate the efficacy and safety of including rebamipide in the eradication regimens for H. pylori infection. Methods: The literature search was conducted in the MEDLINE/PubMed, EMBASE, Cochrane Central Register, Korean Medical Citation Index, and Russian Science Citation Index databases. All identified randomized controlled trials comparing rebamipide supplementation with non-rebamipide-containing eradication regimens for the treatment of H. pylori infection were included in the final analysis. Results: We identified 11 randomized controlled trials (RCTs) involving 1227 patients (631 in groups with rebamipide and 596 in groups without rebamipide). The meta-analysis showed that the addition of rebamipide to eradication regimens significantly increased the effectiveness of treatment (odds ratio (OR) 1.753, 95% confidence interval (CI) 1.312–2.333, p < 0.001). The subgroup analysis demonstrated that rebamipide significantly increased the effectiveness of eradication when added to a dual therapy regimen (OR 1.766, 95% CI: 1.167–2.495, p = 0.006); however, no significant improvement in effectiveness was observed when it was added to the triple therapy regimen (OR 1.638, 95% CI 0.833–3.219, p = 0.152). Conclusion: This meta-analysis demonstrated that the addition of rebamipide to H. pylori eradication regimens significantly increases the effectiveness of treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Efficiency of the Inclusion of Rebamipide in the Eradication Therapy for Helicobacter pylori Infection: Meta-Analysis of Randomized Controlled Studies

Andreev

Маев

Дичева

2019

JCM

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“…Вместе с тем в качестве возможных средств, повышающих эффективность эрадикационной терапии, рекомендуется прием лишь определенных пробиотиков [36]. Помимо этого, последние рекомендации РГА допускают использование цитопротектора -ребамипида при применении тройной терапии для повышения уровня эрадикации микроорганизма [37,38]. Эффективность такого подхода подтверждена недавним метаанализом [39].…”

Section: ðèñ 4 ñõåìû ýðàäèêàöèîííîé òåðàïèè íàçíà÷åííûå â êà÷åñòâåunclassified

European Registry on the management of Helicobacter pylori infection: features of diagnosis and treatment in Kazan

Абдулхаков

Bordin

Абдулхаков³

et al. 2020

Terapevticheskii arkhiv

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Background. As part of an observational multicenter prospective study European Registry on the management of Helicobacter pylori infection, conducted on the initiative of the European H. pylori and Microbiota Study Group, the compliance of clinical practice in the management of patients with Helicobacter pylori infection in Kazan with clinical guidelines was assessed. Materials and methods. The data of 437 patients included into the register by clinical sites in Kazan in 20132019 were analyzed. The methods used for the initial diagnosis of H. pylori infection and eradication control were evaluated. The frequency of various eradication therapy regimens prescription was analyzed in 379 cases. Data regarding the effectiveness of eradication therapy was analyzed in 173 patients. Results. The rapid urease test (44.2% of cases) and cytology/histology (60% of cases) were most often used for the initial diagnosis of H. pylori infection; however non-invasive methods such as 13C-urea breath (9.2%), serology (6.2%), H. pylori stool antigen test (2.3%) were less common. In 21.7% of patients two methods of H. pylori detection were used for primary diagnosis. The control test to evaluate the effectiveness of eradication therapy at the recommended timepoint was performed in 46.2% of patients. 13C-urea breath test (31.7%), stool PCR/stool antigen test (28.7%), rapid urease test (22.3%), cytology/histology (26.2% of cases) prevailed in the assessment of eradication rate. Standard triple therapy, including proton pump inhibitor, clarithromycin and amoxicillin was most commonly prescribed as first-line therapy (64.6% of cases). The duration of eradication therapy was 14 days in the majority of cases with pantoprazole as the most common proton pump inhibitor in standard triple therapy regimens (84.8%). The efficacy of 14-day standard triple therapy (mITT) was 87.0%. Conclusion. The results indicate a high frequency of non-invasive methods use for assessing the effectiveness of eradication therapy; however, the overall rate of eradication efficacy assessment is low, limiting the possibility of analyzing the eradication results. The effectiveness of the most common 14-day standard triple first-line therapy in Kazan doesnt reach the recommended 90% eradication level. This could be explained by high rate of pantoprazole use, which is not an optimal proton pump inhibitor in eradication therapy regimens.

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“…Продолжительность эрадикации -14 дней, терапия четырехкомпонентная (ингибиторы протонной помпы, амоксициллин, кларитромицин, нитромидазол). После неудачной попытки терапии следует провести квадротерапию висмутсодержащую [12,13]. После успешной эрадикации сохраняется эксэрадикационный гастрит, который фиксируется около года при отсутствии прогрессирования атрофии (метаплазии).…”

Section: хронический гастритunclassified

Chronic gastrite: modern state of the problem

Минушкин

Зверков

Lvova³

et al. 2020

Terapevticheskii arkhiv

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Aim. Тo evaluate the modern view on the problem of chronic gastritis and the effectiveness of the drug ursodexic acid (UHC) Grinterol in the treatment of patients with chronic antral reflux-gastritis (biliar). Materials and methods. The work provides modern ideas about chronic gastritis, the issues of etiology and pathogenesis are considered. Contemporary classifications and the attitude of the authors of the work to them are presented. Clinical studies were conducted in 50 patients with chronic antral reflux-gastritis biliary (32 women and 18 men) between the ages of 20 and 80 years (average age 50.3 to 8.0 years). The treatment uses the drug Grinterol in a daily dose of 12.5 mg/kg of body weight for 4 weeks. Results. Among patients with chronic antral gastritis isolated patients with reflux-gastritis biliary, the pathogenetic factor of which is the damaging property of aggressive bile acids. The main treatment for such patients are drugs UHC (in this study (this study uses Grinterol at a daily dose of 12.5 mg/kg of body weight); the duration of treatment is 4 years. The overall efficiency (according to endomorphological data) was 76%, according to clinical data 100%. Discussion. Critical consideration of the classifications used and proposed for consideration indicates that the time has come for the adoption of a new classification with the allocation of reflux-gastritis biliary. Treatment of this form of antral gastritis is effective with UDHC drugs. Conclusion. the selection of a form of antral reflux-gastritis biliar in a separate classification group is scientifically justified. The results suggest that for the treatment of patients with chronic biliary refluxdrugs of choice are drugs UDHC.

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Possibilities for optimization of eradication therapy for Helicobacter pylori infection in modern clinical practice

Cited by 25 publications

References 56 publications

Efficiency of the Inclusion of Rebamipide in the Eradication Therapy for Helicobacter pylori Infection: Meta-Analysis of Randomized Controlled Studies

Efficiency of the Inclusion of Rebamipide in the Eradication Therapy for Helicobacter pylori Infection: Meta-Analysis of Randomized Controlled Studies

European Registry on the management of Helicobacter pylori infection: features of diagnosis and treatment in Kazan

Chronic gastrite: modern state of the problem

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