scholarly journals Bismuth-containing Standard Triple Therapy the First-line Eradication Therapy for Helicobacter pylori

2021 ◽  
Vol 21 (4) ◽  
pp. 354-358
Author(s):  
Yeon-Ji Kim ◽  
Woo Chul Chung
Keyword(s):  
Helicobacter Pylori ◽  
Triple Therapy ◽  
Eradication Therapy ◽  
First Line ◽  
Standard Triple Therapy

scholarly journals CURRENT DEVELOPMENT OF HELICOBACTER PYLORI ERADICATION PROTOCOLS

2021 ◽  
Author(s):  
A. Pozdeeva ◽  
O. Pozdeev ◽  
G. Gulyaev ◽  
Yu. Valeeva ◽  
A. Savinova
Keyword(s):  
Helicobacter Pylori ◽  
Triple Therapy ◽  
High Efficiency ◽  
Eradication Therapy ◽  
Sequential Therapy ◽  
New Drugs ◽  
Antibacterial Drug ◽  
First Line ◽  
Standard Triple Therapy ◽  
H Pylori

Helicobacter pylori is one of the most common commensal microorganisms in the human body, colonizing up to 60% of the inhabitants on all continents. Some H. pylori strains have acquired virulent properties and their presence can significantly complicate the course of type B atrophic gastritis, gastric ulcer and duodenal ulcer, as well as gastric malignant diseases. In such situations, eradication therapy seems to be pathogenetically justified. In 1996, there were proposed the International Recommendations for standard first-line 7–10-day course triple eradication therapy, including a proton pump inhibitor (PPI), amoxicillin and clarithromycin. Until the beginning of the XXIth century, the International Recommendations has been actively and highly efficiently (up to 90%) used everywhere, but later reports started to emerge regarding a catastrophic decrease in therapeutic outcome (up to 60%). Later, it turned out that the effectiveness of the three-component (triple) therapy directly correlates with the resistance to clarithromycin substantially increased in recent decades, which necessitated generation of new schemes for H. pylori elimination. The results of various schemes for H. pylori eradication were analyzed, including variants of modified triple therapy associated with the inclusion of new drugs or prolonged duration of the therapeutic protocol. In particular, it was proposed to replace amoxicillin with metronidazole. However, further studies have shown that the combination of clarithromycin with amoxicillin seems to be preferable due to the high level of H. pylori resistance to metronidazole recorded in many countries. Attempts to use probiotics in parallel, particularly cultures of various Lactobacillus species, were analyzed, which increases the level of eradication during standard triple therapy from 61.5% to 81.6%, and significantly reduces the severity of side effects. It has been shown that a promising approach to increase the effectiveness of 7-day first-line therapy schemes with clarithromycin is to use modern effective PPIs (for example, esomeprazole or rabeprazole). The scheme of modified sequential therapy with the replacement of clarithromycin with tetracycline or levofloxacin, which has shown high efficiency has been considered. A variant of standard triple therapy modified into quadrotherapy by adding metronidazole or tinidazole was analyzed. It has been shown that the sequential therapy scheme is ineffective for eradication of multidrug-resistant strains. Ideally, the treatment of bacterial infections should be based on endoscopic sampling of gastric mucosa biopsies, followed by microbiological determination of in vitro antibacterial drug sensitivity in bacterial isolates.

Su1028 The Trend in Helicobacter pylori Eradication Rates By First-Line Triple Therapy and Related Factors in Eradication Therapy

2016 ◽  
Vol 150 (4) ◽  
pp. S447-S448 ◽  
Author(s):  
Alexander Flores ◽  
Roberto H. Quezada ◽  
Jose M. Valladolid ◽  
Angel Caunedo-Álvarez
Keyword(s):  
Helicobacter Pylori ◽  
Triple Therapy ◽  
Eradication Therapy ◽  
First Line ◽  
Related Factors ◽  
Helicobacter Pylori Eradication

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

2020 ◽  
Vol 92 (8) ◽  
pp. 52-59
Author(s):  
S. R. Abdulkhakov ◽  
D. S. Bordin ◽  
R. A. Abdulkhakov ◽  
D. D. Safina ◽  
A. R. Gizdatullina ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Proton Pump Inhibitor ◽  
Triple Therapy ◽  
Proton Pump ◽  
Eradication Therapy ◽  
Helicobacter Pylori Infection ◽  
Rapid Urease Test ◽  
Standard Triple Therapy ◽  
Urease Test ◽  
H Pylori

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.

scholarly journals Evaluation of the efficacy and safety of the hybrid scheme for eradication therapy of Helicobacter pylori infection

2018 ◽  
Vol 90 (8) ◽  
pp. 33-39 ◽  
Author(s):  
G L Yurenev ◽  
E V Partzvania-Vinogradova ◽  
D N Andreev ◽  
D T Dicheva ◽  
I V Maiev
Keyword(s):  
Helicobacter Pylori ◽  
Adverse Events ◽  
Comparative Study ◽  
Triple Therapy ◽  
Pharmacoeconomic Analysis ◽  
Eradication Therapy ◽  
Efficacy And Safety ◽  
Hybrid Scheme ◽  
Hybrid Therapy ◽  
Standard Triple Therapy

The aim is to conduct a comprehensive comparative study of the efficacy and safety of the hybrid scheme of eradication therapy (ET) in patients with peptic ulcer of the stomach or duodenum associated with Helicobacter pylori. Materials and methods. In a prospective, randomized comparative study, 180 patients were divided into three equal groups of 60 people, depending on the prescribed 10-day ET regimen. Group 1 - the standard triple scheme (omeprazole, amoxicillin and clarithromycin); group 2 - four-component therapy with preparations of bismuth (omeprazole, tetracycline, metronidazole, bismuth tricalium dicitrate); group 3 - hybrid scheme (first 5 days: omeprazole and amoxicillin, the next 5 days: omeprazole, amoxicillin, clarithromycin, metronidazole). The effectiveness of ET was determined with the help of a breath test a month after the end of therapy. Adverse events were recorded by patients in specially developed diaries. Pharmacoeconomic analysis was carried out using the "cost-effectiveness" method with calculation of the CER coefficient. Results and discussion. The effectiveness of standard triple therapy was 73.3% (ITT), 75.9% (PP); four-component therapy with bismuth preparations - 78.3% (ITT), 82.4% (PP); hybrid scheme - 85% (ITT), 91% (PP). Hybrid therapy proved to be significantly more effective than standard triple therapy with a odds ratio (OR) of 3.25; 95% confidence interval (CI) 1.08-9.73 (p=0.043, χ2=4.75, p-level=0.029298). The incidence of adverse events with the use of triple, four-component and hybrid ET regimens was 15; 18.3 and 28.3% respectively. The OR of at least one adverse event in patients receiving a hybrid ET regimen compared with triple therapy was 2.24 (95% CI 0.91-5.53, p=0.0823, χ2=3.14, p-level=0.076394), and compared with the four-component therapy - 1.76 (95% CI 0.74-4.17, p=0.2804, χ2=1.68, p-level=0.194924). According to the results of the pharmacoeconomic analysis, the most profitable from an economic point of view was a hybrid ET scheme with a CER of 20.1. The conclusion. Hybrid therapy showed the greatest effectiveness in comparison with the triple and four-component ET regimens, however, the incidence of side effects in patients receiving the hybrid ET scheme was higher, although it remained within the acceptable level for use in clinical practice. Pharmacoeconomic analysis also showed the advisability of designating a hybrid ET scheme. The obtained data allow to draw a conclusion about the necessity of further study of the efficiency and safety of the hybrid ET scheme.

scholarly journals The Relationship between the Sydney Classification and the First-Line Treatment Efficacy in Helicobacter-Associated Gastritis

2020 ◽  
Vol 29 (6) ◽  
pp. 551-557
Author(s):  
Elif Şenocak Taşçı ◽  
Türkay Akbaş
Keyword(s):  
Success Rate ◽  
Triple Therapy ◽  
Chronic Inflammation ◽  
Precancerous Lesion ◽  
Eradication Therapy ◽  
Ease Of Use ◽  
University Hospital ◽  
First Line ◽  
Standard Triple Therapy ◽  
H Pylori

<b><i>Objective:</i></b> <i>Helicobacter pylori</i>is responsible for a wide spectrum of diseases. Due to ease of use and access, the standard triple therapy is being used as first-line eradication in many areas. Intestinal metaplasia (IM) is a precancerous lesion that requires eradication therapy. Our aim is to investigate the effect of IM on the standard triple therapy success in <i>H. pylori</i>-positive patients. <b><i>Subjects and Methods:</i></b> The patients who were referred to Düzce University Hospital and Avrasya Hospital Gastroenterohepatology clinic between January 2014 and December 2016 and diagnosed with <i>H. pylori</i>-positive gastritis and underwent first-line eradication were evaluated retrospectively. Biopsy specimens were evaluated according to the updated Sydney system. All patients diagnosed with <i>H. pylori</i> started treatment with pantoprazole 40 mg b.i.d., amoxicillin 1 g b.i.d. and clarithromycin 500 mg b.i.d. for 14 days. <b><i>Results:</i></b> The mean age of 181 patients included in the study was 55.5 ± 7.8. The success rate of <i>H. pylori</i> eradication was found to be low in severe chronic inflammation (<i>p</i> = 0.001). The success rate was found to be high among patients with no neutrophil activity (<i>p</i> = 0.009). As the intensity of IM increased, density of <i>H. pylori</i> was found to be decreased (<i>p</i> = 0.019). There was no correlation between glandular atrophy, IM, and <i>H. pylori</i> eradication success rate (<i>p</i> = 0.390 and <i>p</i> = 0.812). <b><i>Conclusion:</i></b> The severity of chronic inflammation is the most effective Sydney criteria for success of eradication, while the presence on IM does not have any effect.

Safety of One-week, First-line, Standard Triple Therapy for Helicobacter pylori Eradication in a Japanese Population

2017 ◽  
Vol 12 (2) ◽  
Author(s):  
Kazutoshi Hori ◽  
Tetsuya Takagawa ◽  
Nobuyuki Hida ◽  
Shiro Nakamura
Keyword(s):  
Helicobacter Pylori ◽  
Triple Therapy ◽  
Japanese Population ◽  
First Line ◽  
Helicobacter Pylori Eradication ◽  
Standard Triple Therapy ◽  
Line Standard

scholarly journals Efficacy of second-line regimens for Helicobacter pylori eradication treatment: a systemic review and network meta-analysis

2020 ◽  
Vol 7 (1) ◽  
pp. e000472 ◽  
Author(s):  
Yen-Lin Chang ◽  
Yu-Chun Tung ◽  
Yu-Kang Tu ◽  
Hong-Zen Yeh ◽  
Jyh-Chin Yang ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Triple Therapy ◽  
Subgroup Analysis ◽  
Meta Analysis ◽  
Eradication Therapy ◽  
Second Line ◽  
First Line ◽  
Quadruple Therapy ◽  
Clarithromycin Resistance ◽  
H Pylori

BackgroundCurrent guidelines recommend bismuth-containing quadruple therapy (BQT) and quinolone-containing therapy after failure of first-line Helicobacter pylori eradication therapy. However, the optimum regimen of second-line eradication therapy remains elusive. We conducted a network meta-analysis to compare the relative efficacy of 16 second-line H. pylori eradication regimens.MethodsThree major bibliographic databases were reviewed to enrol relevant randomised controlled trials between January 2000 and September 2018. Network meta-analysis was conducted by STATA software and we performed subgroup analysis in countries with high clarithromycin resistance and high levofloxacin resistance, and in patients with documented failure of first-line triple therapy.ResultsFifty-four studies totalling 8752 participants who received 16 regimens were eligible for analysis. Compared with a 7-day BQT, use of probiotic add-on therapy during, before, and after second-line antibiotic regimens, quinolone-based sequential therapy for 10–14 days, quinolone-based bismuth quadruple therapy for 10–14 days, bismuth quadruple therapy for 10–14 days, and quinolone-based triple therapy for 10–14 days were significantly superior to the other regimens. Subgroup analysis of countries with high clarithromycin resistance and high levofloxacin resistance revealed that the ranking of second-line eradication regimens was distributed similarly in each group, as well as in patients with failure of first-line triple therapy.ConclusionWe conducted a detailed comparison of second-line H. pylori regimens according to different antibiotic resistance rates and the results suggest alternative treatment choices with potential benefits beyond those that could be achieved using salvage therapies recommended by guidelines.

scholarly journals Сравнительная оценка эффективности 10-дневных схем эрадикации helicobacter pylori инфекции (тройной и тройной с добавлением висмута трикалия дицитрата)

2019 ◽  
pp. 62-65
Keyword(s):  
Helicobacter Pylori ◽  
Triple Therapy ◽  
Eradication Therapy ◽  
Rapid Urease Test ◽  
Eastern Region ◽  
First Line ◽  
Additional Advantage ◽  
Urease Test ◽  
Group 2 ◽  
Group 1

The article presents the results of a comparative study of the efficacy and tolerability of two 10-day eradication therapy regimens of Helicobacter pylori (HP) infection (triple and triple with the addition of bismuth tripotassium dicitrate (BTD). The study involved 158 patients with HP-associated pathology (dispepsia, erosive and ulcerative lesions of the gastroduodenal mucosa) from 18 to 65 years of age (mean age=44,6±13,5 years): 57 men (36,1 %), 101 women (63,9 %). The diagnostics of HP-infection performed using a rapid urease test (Helpil test St'Petersburg) in the course fibrogastroduodenoscopy (FGDS). The patients were divided randomly into two groups. In the group 1, 75 patients received classical first-line triple therapy: esomeprazole 20 mg twice a day, amoxicillin 1 000 mg twice a day, clarithromycin 500 mg twice a day. In the group 2, 83 patients received treatment using a similar regimen, but with the addition of BTD 240 mg twice a day. The duration of treatment in both groups was 10 days. The effectiveness of the eradication therapy was evaluated after 6-8 weeks of the end of the treatment course by means of qualitative rapid determination of fecal HP antigens using the method of immunochromatography with monoclonal antibodies (Vegal Farmaceutica, Spain). Out of the 75 patients in group 1, 60 (80 %) showed eradication of HP infection was achieved. Out of 83 patients in group 2, the eradication of HP infection was achieved in 76 patients (92,5 %). The difference in the effectiveness of eradication therapy in patients in group 1 and group 2 is statistically significant (p<0,05). Thus, the classical 10-day regimen of triple antihelicobacter therapy is not effective enough and is not recommended for use in clinical practice in Khabarovsk. A 10-day triple therapy with the addition of BTD is highly effective in the Far Eastern region (Khabarovsk) and recommended as a first-line therapy. A significant reduction in the adverse events frequency in the form of bitter taste in the mouth and diarrhea is an additional advantage of the regimen using bismuth tripotassium dicitrate in comparison with the classical regimen of the triple antihelicobacter therapy.

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