Sequential Therapy versus Standard Triple Therapy for Helicobacter Pylori Eradication in Iran
A double-blind, randomized, placebo-controlled trial
Keywords:
Helicobacter pylori, Sequential therapy, Triple therapyAbstract
Background and aim: Currently, different regimens are used for Helicobacter pylori eradication. The aim of this study is to compare the efficacy and safety of sequential and standard triple therapy for Helicobacter pylori eradication in Bandar Abbas in 2018. Methods: This randomized controlled trial was done on 150 patients in Bandar Abbas in 2018. Patients were randomly assigned into two groups either to receive standard triple therapy or sequential therapy for Helicobacter pylori eradication. Patients were followed for helicobacter eradication, minor and major side effects and drug intolerance. Data were analyzed using SPSS 23.0 software. Results: Two groups were similar in baseline characteristics. Helicobacter pylori eradication was reported in 70 (90.9 %) in the sequential and 54 (74 %) in the standard triple therapy group (p=0.006). Minor side effects were reported in 20 (26 %) in the sequential and 36 (49.3 %) in the standard triple therapy (p=0.003). Major side effects (p=0.142) and drug intolerance (p=0.480) were similar in both groups. Conclusion: Sequential therapy is more effective and has lower rate of minor complications in eradication of Helicobacter pylori. Trial registration: The protocol of study was registered at the Iranian Registry of Clinical Trials (IRCT) with ID number of IRCT20180131038581N2. Funding: Hormozgan University of Medical Sciences, thesis number: 93-95/231References
Go MF. Review article: natural history and epidemiology of Helicobacter pylori infection. Alimentarypharmacology & therapeutics. 2002 Mar;16 Suppl 1:3-15. PubMed PMID: 11849122. doi: 10.1046/j.1365-2036.2002.0160s1003.x2)Khan MA, Ghazi HO. Helicobacter pylori infection in asymptomatic subjects in Makkah, Saudi Arabia.JPMA The Journal of thePakistan Medical Association. 2007 Mar;57(3):114-7. PMID: 17432012.3)Marie MA. Seroprevalence of Helicobacter pylori Infection in Large Series of Patients in an Urban Area ofSaudi Arabia. The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi.2008 Oct;52(4):226-9. PMID: 19077524.4)Akbar DH, Eltahawy AT. Helicobacter pylori infection at a university hospital in Saudi Arabia: Prevalence,comparison of diagnostic modalities and endoscopic findings. Indian J Pathol Microbiol. 2005;48:181–5.PMid: 167586595)Ayoola AE, Ageely HM, Gadour MO, Pathak VP. Prevalence of Helicobacter pylori infection amongpatients with dyspepsia in South-Western Saudi Arabia. Saudi Med J. 2004;25:1433–8. PMid: 154948176)Suerbaum S, Michetti P. Helicobacter pylori infection.The New England journal of medicine. 2002 Oct10;347(15):1175-86. PMID: 12374879. doi: 10.1056/NEJMra0205427)Bayerdorffer E, Neubauer A, Rudolph B, Thiede C, Lehn N, Eidt S, et al. Regression of primary gastriclymphoma of mucosa-associated lymphoid tissuetype after cure of Helicobacter pylori infection. MALTLymphoma Study Group. Lancet. 1995 Jun 24;345(8965):1591-4. PMID: 7783535. doi: 10.1016/S0140-6736(95)90113-28)Malfertheiner P, Megraud F, O'morain CA, Atherton J, Axon AT, Bazzoli F, et al. ManagementofHelicobacter pylori infection—the Maastricht IV/Florence consensus report. Gut. 2012;61(5):646-64. doi:10.1136/gutjnl-2012-302084, PMid: 224914999)Graham DY, Fischbach L. Helicobacter pylori treatment in the era of increasing antibiotic resistance. Gut.2010 Aug;59(8):1143-53. PMID: 20525969. doi: 10.1136/gut.2009.19275710)Eltahawy AT. Prevalence of primary Helicobacter pylori resistance to several antimicrobials in a SaudiTeaching Hospital. Med Princ Pract. 2002;11:65–8. doi: 10.1159/000058009, PMid: 1212310511)Qasim A, Sebastian S, Thornton O, Dobson M, McLoughlin R, Buckley M, et al. Rifabutin‐andfurazolidone‐based Helicobacter pylori eradication therapies after failure of standard first‐and second‐line eradication attempts in dyspepsia patients. Alimentary pharmacology & therapeutics. 2005;21(1):91-6.doi: 10.1111/j.1365-2036.2004.02210.x, PMid: 1564405012)Gatta L, Zullo A, Perna F, Ricci C, De Francesco V, Tampieri A, et al. A 10‐day levofloxacin‐basedtriple therapy in patients who have failed two eradication courses. Alimentary pharmacology &therapeutics. 2005;22(1):45-9. doi: 10.1111/j.1365-2036.2005.02522.x, PMid: 15963079
Gisbert JP, Gonzalez L, Calvet X. Systematic Review and Meta‐analysis: Proton Pump Inhibitor vs.Ranitidine Bismuth Citrate Plus Two Antibiotics in Helicobacter pylori Eradication. Helicobacter.2005;10(3):157-71. doi: 10.1111/j.1523-5378.2005.00307.x, PMid: 1590447314)Fischbach L, Zanten S, Dickason J. Meta‐analysis: the efficacy, adverse events, and adherence related tofirst‐line anti‐Helicobacter pylori quadruple therapies. Alimentary pharmacology & therapeutics.2004;20(10):1071-82. doi: 10.1111/j.1365-2036.2004.02248.x, PMid: 1556910915)Graham D, Hammoud F, El‐Zimaity H, Kim J, Osato M, El‐Serag H. Meta‐analysis: proton pumpinhibitor or H2‐receptor antagonist for Helicobacter pylori eradication. Alimentary pharmacology &therapeutics. 2003;17(10):1229-36. doi: 10.1046/j.1365-2036.2003.01583.x16)Jafri NS, Hornung CA, Howden CW. Meta-analysis: sequential therapy appears superior to standardtherapy for Helicobacter pylori infection in patients naive to treatment. Annals of internal medicine. 2008Jun 17;148(12):923-31. PMID: 18490667. doi: 10.7326/0003-4819-148-12-200806170-0022617)Yuan Y, Ford AC, Khan KJ, Gisbert JP, Forman D, LeontiadisGI, et al. Optimum duration of regimens forHelicobacter pylori eradication. Cochrane Database of Systematic Reviews. 2013;12. doi:10.1002/14651858.CD008337.pub218)Seddik H, Ahid S, El Adioui T, El Hamdi F-Z, Hassar M, Abouqal R, et al. Sequential therapyversusstandard triple-drug therapy for Helicobacter pylori eradication: a prospective randomized study. Europeanjournal of clinical pharmacology. 2013;69(9):1709-15. doi: 10.1007/s00228-013-1524-6, PMid: 2369554519)Nasa M, Choksey A, Phadke A, Sawant P. Sequential therapy versus standard triple-drug therapy forHelicobacter pylori eradication: a randomized study. Indian Journal of Gastroenterology. 2013;32(6):392-6.doi: 10.1007/s12664-013-0357-7, PMid: 2415889820)Lahbabi M, Alaoui S, El Rhazi K, El Abkari M,Nejjari C, Amarti A, et al. Sequential therapy versusstandard triple-drug therapy for Helicobacter pylori eradication: result of the HPFEZ randomised study.Clinics and research in hepatology and gastroenterology. 2013;37(4):416-21. doi:10.1016/j.clinre.2012.10.002, PMid: 2316822821)Vaira D, Zullo A, Vakil N, Gatta L, Ricci C, Perna F, et al. Sequential therapy versus standard triple-drugtherapy for Helicobacter pylori eradication: a randomized trial. Annals of Internal Medicine.2007;146(8):556-63. doi:10.7326/0003-4819-146-8-200704170-00006, PMid: 1743831422)Nyssen OP, McNicholl AG, Megraud F, Savarino V, Oderda G, Fallone CA, et al. Sequential versusstandard triple first‐line therapy for Helicobacter pylori eradication. The Cochrane Library. 2016. doi:10.1002/14651858.CD009034.pub2
Downloads
Published
Issue
Section
License
Copyright (c) 2020 Knowledge Kingdom Publishing
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.