Sequential Therapy versus Triple Therapy for the First Line Treatment of Helicobacter pylori in Korea: A Nationwide Randomized Trial

被引:21
作者
Kim, Joon Sung [1 ]
Kim, Byung-Wook [1 ]
Hong, Su Jin [2 ]
Kim, Jin Il [3 ]
Shim, Ki-Nam [4 ]
Kim, Jie-Hyun [5 ]
Baik, Gwang Ho [6 ]
Kim, Sang Wook [7 ]
Song, Hyun Joo [8 ]
Kim, Ji Hyun [9 ]
机构
[1] Catholic Univ Korea, Coll Med, Incheon St Marys Hosp, Dept Internal Med, Inchon, South Korea
[2] Soonchunhyang Univ, Coll Med, Dept Internal Med, Bucheon, South Korea
[3] Catholic Univ Korea, Coll Med, Yeouido St Marys Hosp, Dept Internal Med, Seoul, South Korea
[4] Ewha Womans Univ, Sch Med, Ewha Med Res Inst, Dept Internal Med, Seoul, South Korea
[5] Yonsei Univ, Coll Med, Dept Internal Med, Seoul, South Korea
[6] Hallym Univ, Coll Med, Dept Internal Med, Chunchon, South Korea
[7] Chonbuk Natl Univ, Sch Med, Dept Internal Med, Jeonju, South Korea
[8] Jeju Natl Univ, Sch Med, Dept Internal Med, Jeju, South Korea
[9] Inje Univ, Coll Med, Busan Paik Hosp, Dept Internal Med, Busan, South Korea
关键词
Helicobacter pylori; Drug resistance; Disease eradication; ERADICATION RATES; ANTIBIOTIC-RESISTANCE; CONSENSUS CONFERENCE; SOUTH-KOREA; INFECTION; METAANALYSIS; LEVOFLOXACIN; MANAGEMENT; 2ND-LINE; FAILURE;
D O I
10.5009/gnl15470
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background/Aims: Eradication of Helicobacter pylori infection with standard triple therapy (TT) has declined primarily because of increased antibiotic resistance. Sequential therapy (ST) has been suggested as an alternative to TT for the first-line treatment of H. pylori. The purpose of this study was to compare the efficacy of ST with TT. Methods: This was a multicenter, randomized open-label trial performed at nine centers in Korea. Patients with H. pylori infection were randomly assigned to receive either 7 day TT or 10 day ST. Eradication rates, drug compliance, and adverse events were Compared among the two regimens. Results: A total of 601 patients were enrolled between March 2011 and September 2014. The intention-to-treat eradication rates were 70.8% for TT and 82.4% for ST (p=0.001). The corresponding per protocol eradication rates were 76.9% and 88.8% for TT and ST, respectively (p=0.000). There were no statistically significant differences between the two regimens with respect to drug compliance and adverse events. Conclusions: ST achieved better eradication rates than TT as a first-line therapy for H. pylori eradication in Korea.
引用
收藏
页码:556 / 561
页数:6
相关论文
共 36 条
[1]   Antibiotic Resistance in Helicobacter pylori Strains and its Effect on H-pylori Eradication Rates in a Single Center in Korea [J].
An, Byoungrak ;
Moon, Byung Soo ;
Kim, Heejung ;
Lim, Hyun Chul ;
Lee, Yong Chan ;
Lee, Gyusang ;
Kim, Sa-Hyun ;
Park, Min ;
Kim, Jong Bae .
ANNALS OF LABORATORY MEDICINE, 2013, 33 (06) :415-419
[2]   Science, medicine, and the future -: Helicobacter pylori and gastric diseases [J].
Blaser, MJ .
BRITISH MEDICAL JOURNAL, 1998, 316 (7143) :1507-1510
[3]   Preventing recurrent upper gastrointestinal bleeding in patients with Helicobacter pylori infection who are taking low-dose aspirin or naproxen [J].
Chan, FKL ;
Chung, SCS ;
Suen, BY ;
Lee, YT ;
Leung, WK ;
Leung, VKS ;
Wu, JCY ;
Lau, JYW ;
Hui, Y ;
Lai, MS ;
Chan, HLY ;
Sung, JJY .
NEW ENGLAND JOURNAL OF MEDICINE, 2001, 344 (13) :967-973
[4]   American college of gastroenterology guideline on the management of Helicobacter pylori infection [J].
Chey, William D. ;
Wong, Benjamin C. Y. .
AMERICAN JOURNAL OF GASTROENTEROLOGY, 2007, 102 (08) :1808-1825
[5]   Latin-American consensus conference on Helicobacter pylori infection [J].
Coelho, LGV ;
León-Barúa, R ;
Quigley, EMM .
AMERICAN JOURNAL OF GASTROENTEROLOGY, 2000, 95 (10) :2688-2691
[6]   Chemoprevention of gastric dysplasia:: Randomized trial of antioxidant supplements and anti-Helicobacter pylori therapy [J].
Correa, P ;
Fontham, ETH ;
Bravo, JC ;
Bravo, LE ;
Ruiz, B ;
Zarama, G ;
Realpe, JL ;
Malcom, GT ;
Li, D ;
Johnson, WD ;
Mera, R .
JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE, 2000, 92 (23) :1881-1888
[7]   Global eradication rates for Helicobacter pylori infection: systematic review and meta-analysis of sequential therapy [J].
Gatta, Luigi ;
Vakil, Nimish ;
Vaira, Dino ;
Scarpignato, Carmelo .
BMJ-BRITISH MEDICAL JOURNAL, 2013, 347
[8]   Sequential Therapy or Triple Therapy for Helicobacter pylori Infection: Systematic Review and Meta-Analysis of Randomized Controlled Trials in Adults and Children [J].
Gatta, Luigi ;
Vakil, Nimish ;
Leandro, Gioacchino ;
Di Mario, Francesco ;
Vaira, Dino .
AMERICAN JOURNAL OF GASTROENTEROLOGY, 2009, 104 (12) :3069-3079
[9]   Review article: the effectiveness of standard triple therapy for Helicobacter pylori has not changed over the last decade, but it is not good enough [J].
Gisbert, J. P. ;
Calvet, X. .
ALIMENTARY PHARMACOLOGY & THERAPEUTICS, 2011, 34 (11-12) :1255-1268
[10]   Second-line rescue therapy with levofloxacin after H-Pylori treatment failure:: A Spanish multicenter study of 300 patients [J].
Gisbert, Javier P. ;
Bermejo, Fernando ;
Castro-Fernandez, Manuel ;
Perez-Aisa, Angeles ;
Fernandez-Bermejo, Miguel ;
Tomas, Albert ;
Barrio, Jose ;
Bory, Felipe ;
Almela, Pedro ;
Sanchez-Pobre, Pilar ;
Cosme, Angel ;
Ortiz, Vicente ;
Nino, Pilar ;
Khorrami, Sam ;
Benito, Luis-Miguel ;
Carneros, Jose-Antonio ;
Lamas, Eloisa ;
Modolell, Ines ;
Franco, Alejandro ;
Ortuno, Juan ;
Rodrigo, Luis ;
Garcia-Duran, Fernando ;
O'Callaghan, Elena ;
Ponce, Julio ;
Valer, Maria-Paz ;
Calvet, Xavier .
AMERICAN JOURNAL OF GASTROENTEROLOGY, 2008, 103 (01) :71-76