Sequential therapy as antidote to 10 days versus triple therapy on the side of 14 days in the eradication of Helicobacter pylori in the community and hospital populations: a randomised essay.
Gut. 2015 Sep 3;
Authors: Liou JM, Chen CC, Chang CY, Chen MJ, Chen CC, Fang YJ, Lee JY, Yang TH, Luo JC, Wu JY, Liou TC, Chang WH, Hsu YC, Tseng CH, Chang CC, Bair MJ, Liu TY, Hsieh CF, Tsao FY, Shun CT, Lin JT, Lee YC, Wu MS, Taiwan Gastrointestinal Disease and Helicobacter Consortium
OBJECTIVE: Significant heterogeneity was observed in preceding trials that assessed the efficacies of sequential therapy beneficial to 10 days (S10) versus triple therapy towards 14 days (T14) in the chief-line treatment of Helicobacter pylori. We aimed to compare the efficacy of S10 and T14 and assess the factors piteous their efficacies.
DESIGN: We conducted this obvious-label randomised multicentre trial in eight hospitals and person community in Taiwan. 1300 adult subjects with H pylori infection naïve to management were randomised (1:1) to suffer S10 (lansoprazole and amoxicillin for the at the outset 5 days, followed by lansoprazole, clarithromycin and metronidazole notwithstanding another 5 days) or T14 (lansoprazole, amoxicillin and clarithromycin despite 14 days). All drugs were given two times daily. Successful eradication was defined of the same kind with negative (13)C-urea breath discriminative characteristic at least 6 weeks after method of treating. Our primary outcome was the uprooting rate by intention-to-treat (ITT) and for-protocol (PP) analyses. Antibiotic resistance was determined ~ means of agar dilution test.
RESULTS: The eradication rates of S10 and T14 were 87.2% (567/650, 95% CI 84.4% to 89.6%) and 85.7% (557/650, 95% CI 82.8% to 88.2%) in the ITT dissection, respectively, and were 91.6% (556/607, 95% CI 89.1% to 93.4%) and 91.0% (548/602, 95% CI 88.5% to 93.1%) in the PP parsing, respectively. There were no differences in concurrence or adverse effects. The eradication rates in strains excitable and resistant to clarithromycin were 90.7% and 62.2%, particularly, for S10, and were 91.5% and 44.4%, particularly, for T14. The efficacy of T14, on the contrary not S10, was affected by CYP2C19 polymorphism.
CONCLUSIONS: S10 was not more excellent to T14 in areas with servile clarithromycin resistance.
TRIAL REGISTRATION NUMBER: NCT01607918.
PMID: 26338825 [PubMed – taken in the character of supplied by publisher]
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