Randomized clinical trial comparing 10-day sequential, 7-day concomitant and 7-day standard triple therapies for Helicobacter pylori eradication

Tepeš, Bojan; Vujasinović, Miroslav; Šeruga, Maja; Stefanović, Milan; Forte, Alenka; Jeverica, Samo

doi:10.1097/meg.0000000000000590

Cited by 22 publications

(24 citation statements)

References 24 publications

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“…When considering only data from studies published in the last 5 years, the cure rate following sequential therapy was still 90-92.6% in 5 Italian studies with more than 1000 patients [26,38-41], and 73% in another study with 100 cases [42]. A similarly high success rate of sequential therapy has been observed in studies recently performed in Slovenia (94.2%) [43], Portugal (90%) [44], Belgium (90%) [3], Israel (95.9%) [45], Thailand (94%) [46], Taiwan (91.9%) [47], Singapore (90.3%) [48], and the United Arab Emirates (88.6%) [49], suggesting that this therapy is still effective in several countries. Based on these findings, Italian, Slovenian, or Portuguese physicians could inopportunely deprive their patients a priori of a still effective therapy by following the European guidelines.…”

Section: Bismuth-free Therapiesmentioning

confidence: 89%

First-line therapies for Helicobacter pylori eradication: a critical reappraisal of updated guidelines

Francesco¹,

Bellesia²,

Manta

et al. 2017

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Helicobacter pylori (H. pylori) treatment remains a challenge for the clinician, as no available therapy is able to cure the infection in all treated patients. In the last two decades, several antibiotic combinations have been proposed, including triple therapies, bismuth-free therapies (sequential, concomitant, hybrid regimens), and bismuth-based quadruple therapy. Some national and international guidelines on H. pylori management have recently been updated, recommending or discouraging the use of each of these therapeutic approaches, based mainly on the presumed pattern of primary antibiotic resistance in different geographic areas. We examined the recommendations on first-line therapies in the most recently updated guidelines worldwide, taking into account other data affecting the efficacy of a therapy regimen beyond the primary resistance pattern. Although several guidelines highlighted that the results achieved by an eradication therapy are population-specific and not directly transferable, it emerged that some therapy regimens are recommended or discouraged with no mention of the vital need for national data.

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Section: Bismuth-free Therapiesmentioning

confidence: 89%

First-line therapies for Helicobacter pylori eradication: a critical reappraisal of updated guidelines

Francesco¹,

Bellesia²,

Manta

et al. 2017

aog

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“…A third study from Taiwan also showed an advantage but again failed to show statistical superiority for ST (83.5% vs 77.3%) . Another paper from Slovenia showed more promising results with 94.2% eradication with a 10‐day ST compared to 83.6% for 7‐day standard triple therapy and 91.7% for 7‐day concomitant therapy with the superiority over triple therapy reaching statistical significance …”

Section: Sequential Therapymentioning

confidence: 98%

Treatment of Helicobacter pylori infection 2016

et al. 2016

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Many interesting articles have been published from different parts of the world over the last year assessing various issues around Helicobacter pylori eradication therapy. This article will address the published literature over the last year pertaining to the topic of treatment of H. pylori infection. The main themes that emerge are assessing the efficacy of standard triple therapy, as well as exploring new first-line treatments, mainly optimized nonbismuth-containing and bismuth-containing quadruple therapies with some promising data also emerging on dual therapy. There was also considerable progress in investigating antibiotic resistance rates with much more data emerging from varied parts of the world compared to recent years. Advances in the use of adjunctive therapies, especially probiotic therapies have also been made. Undoubtedly, the eradication of H. pylori remains a worthwhile goal to alleviate the burden of diseases caused by the complications of this infection, including dyspepsia, peptic ulcer disease, and gastric cancer.

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“…However, higher compliance was achieved with concomitant therapy than with sequential therapy in a meta-analysis of RCTs in Chinese regions [58]. Concomitant therapy is known to demonstrate better eradication rates in patients with clarithromycin- or metronidazole-resistant strains [59, 60], and the selection of secondary antibiotics after first-line concomitant therapy failure remains challenging.…”

Section: First-line Treatment Options For Cases With High Antibiotmentioning

confidence: 99%

Optimal First-Line Treatment forHelicobacter pyloriInfection: Recent Strategies

Lee

Park

2016

Gastroenterology Research and Practice

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A new treatment strategy is needed, as the efficacy of triple therapy containing clarithromycin—the current standard treatment for Helicobacter pylori infection—is declining. Increasing antibiotic resistance of H. pylori is the most significant factor contributing to eradication failure. Thus, selecting the most appropriate regimen depending on resistance is optimal, but identifying resistance to specific antibiotics is clinically challenging. In a region suspected to have high clarithromycin resistance, bismuth quadruple therapy and so-called nonbismuth quadruple therapies (sequential, concomitant, and sequential-concomitant hybrid) are some first-line regimen options. However, more research is needed regarding appropriate second-line treatments after first-line treatment failure. Tailored therapy, which is based on antibiotic sensitivity testing, would be optimal but has several limitations for clinical use, and an alternative technique is required. A novel potassium-competitive acid blocker-based eradication regimen could be a valuable eradication option in the near future.

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Randomized clinical trial comparing 10-day sequential, 7-day concomitant and 7-day standard triple therapies for Helicobacter pylori eradication

Cited by 22 publications

References 24 publications

First-line therapies for Helicobacter pylori eradication: a critical reappraisal of updated guidelines

First-line therapies for Helicobacter pylori eradication: a critical reappraisal of updated guidelines

Treatment of Helicobacter pylori infection 2016

Optimal First-Line Treatment forHelicobacter pyloriInfection: Recent Strategies

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