The Toronto Consensus for the Treatment of Helicobacter pylori Infection in Adults

Fallone, Carlo A; Chiba, Naoki; Zanten, Sander Veldhuyzen van; Fischbach, Lori; Gisbert, Javier P.; Hunt, Richard H.; Jones, Nicola L.; Render, Craig; Leontiadis, Grigorios I; Martin, Paul; Marshall, John K.

doi:10.1053/j.gastro.2016.04.006

Cited by 714 publications

(887 citation statements)

References 131 publications

(210 reference statements)

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“…We do not address the management of organic pathology that may present with dyspepsia identifi ed at endoscopy, such as esophagitis or peptic ulcer disease as there are other ACG guidelines for these specifi c diseases ( 17 ). Further, when H. pylori testing or treatment is recommended we do not specify which investigation or which therapy to use, as this will be addressed in an ACG guideline on H. pylori and other recent guidelines have been published ( 18 ). Th e treatment sections warrant an important caveat.…”

Section: Acg and Cag Clinical Guideline: Management Of Dyspepsiamentioning

confidence: 99%

ACG and CAG Clinical Guideline: Management of Dyspepsia

Martin

Lacy

Andrews

et al. 2017

American Journal of Gastroenterology

469

506

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Section: Acg and Cag Clinical Guideline: Management Of Dyspepsiamentioning

confidence: 99%

ACG and CAG Clinical Guideline: Management of Dyspepsia

Martin

Lacy

Andrews

et al. 2017

American Journal of Gastroenterology

469

506

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“…According to the Toronto consensus [3], a meta-analysis of data from randomized controlled trials (RCTs) assessing bismuth quadruple therapy after failure of standard triple therapy reported an eradication success rate of 78% (95% CI, 75% -81%). There was a trend toward higher eradication rates with longer durations of therapy.…”

Section: Discussionmentioning

confidence: 99%

“…Curative treatment of H. pylori infection was proved to markedly reduce the rate of recurrence of a variety of gastroduodenal diseases [2] [3]. In 2014, The International Agency for Research on Cancer (IARC) Working Group recommended H. pylori eradication as a strategy for preventing gastric cancer [4].…”

Section: Introductionmentioning

confidence: 99%

“…Several approaches were proposed to overcome these low eradication rates; either sequential therapy or concomitant therapy achieved better results than standard triple therapy [9] [10]. The latest guidelines recommended quadruple therapies comprised of PPI + AMPC + CAM + metronidazole (MNZ) or PPI + bismuth + MNZ + tetracycline, with all treatments given for 14 days [2] [3].…”

Section: Introductionmentioning

confidence: 99%

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Efficacy and Tolerability of Second-Line Metronidazole Triple Therapy Using Vonoprazan for Helicobacter pylori Eradication in Japan—Comparative Study: Vonoprazan vs. Proton Pump Inhibitors

Ohtaka¹,

Miura²,

Hanawa³

et al. 2018

OJGas

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Aim: To investigate the efficacy and tolerability of second-line metronidazole triple therapy with vonoprazan (VPZ) for Helicobacter pylori (H. pylori).Methods: We retrospectively reviewed medical records of patients who experienced clarithromycin triple therapy failure and were treated with secondline (20 mg VPZ (n = 274)/30 mg lansoprazole (n = 323) or 10 mg rabeprazole (n = 141) twice daily, 750 mg amoxicillin twice daily, 250 mg metronidazole twice daily for 7 days) eradication therapies. Successful eradication rates were compared between two groups: those receiving VPZ and those receiving a proton pump inhibitor (PPI). Adverse events were also investigated. Results: Successful second-line eradication rates according to ITT analysis and PP analysis, respectively, were 79.9% and 92.4% for VPZ therapy and 83.6% and 93.3% for PPI therapy. There were no significant differences between treatment groups. The eradication rates in those who had received first-line VPZ therapy previously according to ITT and PP analysis were 75.2% and 88.1%, respectively; in contrast, values were 82.5% and 95.4%, respectively, for those who had received first-line PPI therapy previously. In second-line therapy, the overall adverse event rate for VPZ therapy was the same as for PPI therapy. Conclusions: The efficacy and tolerability of metronidazole-containing second-line triple therapy with VPZ or a PPI were equivalent.How to cite this paper: Ohtaka, M., Miura, M., Hanawa, M.,

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“…Curative treatment of H. pylori infection was proved to markedly reduce the rate of relapse of a variety of gastroduodenal diseases [2] [3]. In 2014, The International Agency for Research on Cancer (IARC) Working Group recommended H. pylori eradication as a strategy for preventing gastric cancer [4].…”

Section: Introductionmentioning

confidence: 99%

Gastric Mucosal Atrophy Might Be Associated with the Efficacy of First-Line Therapy Using Vonoprazan for <i>Helicobacter pylori</i>

Miura¹,

Ohtaka²,

Hanawa³

et al. 2017

OJGas

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Aim: To investigate the factors related to the effect of eradication therapy with vonoprazan for Helicobacter pylori (H. pylori). Methods: We retrospectively reviewed medical records of H. pylori-positive patients who received first-line (40 mg vonoprazan/60 mg lansoprazole or 20 mg rabeprazole, 1500 mg amoxicillin, 400 mg clarithromycin, all 2/day for 7 days) (n = 4118). H. pylori eradication was assessed by the 13 C-urea breath test with success defined as a result of < 2.5‰. Using propensity score matching, successful eradication rates were compared between two groups: those receiving vonoprazan and those receiving a proton pump inhibitor. Related factors and adverse events were investigated. Results: Successful first-line eradication rates according to ITT analysis and PP analysis, respectively, were 79.8% and 91.4% for VPZ therapy. Eradication rates using propensity matched patients (n = 1053) who received first-line vonoprazan therapy were higher than in those using proton pump inhibitor (PPI) therapy (92.1% vs. 79.7% in per-protocol analysis, p < 0.0001). Multivariate analysis confirmed that gastric mucosal atrophy was associated with treatment success. Conclusions: Low-dose clarithromycin triple therapy for first-line H. pylori eradication therapy using vonoprazan was more effective than standard triple therapy with proton pump inhibitor. Gastric mucosal atrophy was associated with treatment success.

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The Toronto Consensus for the Treatment of Helicobacter pylori Infection in Adults

Cited by 714 publications

References 131 publications

ACG and CAG Clinical Guideline: Management of Dyspepsia

ACG and CAG Clinical Guideline: Management of Dyspepsia

Efficacy and Tolerability of Second-Line Metronidazole Triple Therapy Using Vonoprazan for Helicobacter pylori Eradication in Japan—Comparative Study: Vonoprazan vs. Proton Pump Inhibitors

Gastric Mucosal Atrophy Might Be Associated with the Efficacy of First-Line Therapy Using Vonoprazan for <i>Helicobacter pylori</i>

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The Toronto Consensus for the Treatment of Helicobacter pylori Infection in Adults

Cited by 714 publications

References 131 publications

ACG and CAG Clinical Guideline: Management of Dyspepsia

ACG and CAG Clinical Guideline: Management of Dyspepsia

Efficacy and Tolerability of Second-Line Metronidazole Triple Therapy Using Vonoprazan for Helicobacter pylori Eradication in Japan—Comparative Study: Vonoprazan vs. Proton Pump Inhibitors

Gastric Mucosal Atrophy Might Be Associated with the Efficacy of First-Line Therapy Using Vonoprazan for &lt;i&gt;Helicobacter pylori&lt;/i&gt;

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Gastric Mucosal Atrophy Might Be Associated with the Efficacy of First-Line Therapy Using Vonoprazan for <i>Helicobacter pylori</i>