The multicenter real-world report of the efficacies of 14-day esomeprazole-based and rabeprazole-based high-dose dual therapy in first-line Helicobacter pylori eradication in Taiwan.
J Microbiol Immunol Infect
; 57(4): 601-608, 2024 Aug.
Article
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| MEDLINE
| ID: mdl-38461114
ABSTRACT
BACKGROUND:
High-dose dual therapy (HDDT) using proton-pump inhibitors (PPI) and amoxicillin attracted attention for its simplicity and lower adverse event profile. Besides, vonoprazan is not available worldwide. This real-world study aims to compare the efficacy of esomeprazole-based and rabeprazole-based HDDT regimens and to identify clinical factors influencing outcomes.METHODS:
A retrospective study enrolled 346 Helicobacter pylori-infected naïve patients from January 2016 to August 2023. Patients were assigned to either a 14-day esomeprazole-based HDDT (EA-14; esomeprazole 40 mg t.i.d. and amoxicillin 750 mg q.i.d. for 14 days, n = 173) or a 14-day rabeprazole-based HDDT (RA-14; rabeprazole 20 mg and amoxicillin 750 mg q.i.d. for 14 days, n = 173).RESULTS:
Five patients from the EA-14 group and 10 from the RA-14 group were lost to follow-up, resulting in 168 and 163 patients for the per-protocol (PP) analysis, respectively. Eradication rates for the EA-14 and RA-14 groups were 90.2% and 80.9% (P = 0.014) in intention-to-treat (ITT) analysis; and 92.9% and 85.9% (P = 0.039) in PP analysis. Adverse event rates were similar between the two groups (11.9% vs 11.7%, P = 0.944). In multiple logistic regression analysis, ageâ§60 was associated with eradication failure (P = 0.046) and a trend of significance for smoking (P = 0.060) in the EA-14 group but not in the RA-14 group. A trend of significance was also observed for eradication regimens (EA-14 vs RA-14) (P = 0.071). The antibiotic resistance rates were amoxicillin (2.3%), clarithromycin (14.7%), metronidazole (40.3%), and dual resistance to clarithromycin and metronidazole (7.0%).CONCLUSIONS:
Esomeprazole-based HDDT achieved over 90% eradication rates but rabeprazole-based HDDT, which failed.Palabras clave
Texto completo:
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Base de datos:
MEDLINE
Asunto principal:
Helicobacter pylori
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Infecciones por Helicobacter
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Quimioterapia Combinada
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Inhibidores de la Bomba de Protones
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Esomeprazol
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Rabeprazol
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Amoxicilina
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Antibacterianos
Límite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
País/Región como asunto:
Asia
Idioma:
En
Revista:
J Microbiol Immunol Infect
/
J. microbiol. immunol. infect.
/
Journal of microbiology, immunology and infection
Asunto de la revista:
ALERGIA E IMUNOLOGIA
/
MICROBIOLOGIA
Año:
2024
Tipo del documento:
Article
País de afiliación:
Taiwán