Randomized Controlled Trial for Helicobacter pylori Eradication in a Naive Portuguese Population: Is Sequential Treatment Superior to Triple Therapy in Real World Clinical Setting?
Autor(a) principal: | |
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Data de Publicação: | 2017 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8072 |
Resumo: | Introduction: Helicobacter pylori eradication has become increasingly difficult as resistances to several antibiotics develop. We aimed to compare Helicobacter pylori eradication rates between triple therapy and sequential therapy in a naive Portuguese population.Material and Methods: Prospective randomized trial including consecutive patients referred for first-line Helicobacter pylori eradication treatment. Exclusion criteria: previous gastric surgery/neoplasia, pregnancy/lactancy, allergy to any of the drugs. The compared eradication regimens were triple therapy (pantoprazol, amoxicillin and clarithromycin 12/12 hours, 14 days) and sequential therapy (pantoprazol 12/12 hours for 10 days, amoxicillin 12/12 hours for days 1 - 5 and clarithromycin plus metronidazol 12/12 hours during days 6 - 10). Eradication success was confirmed with urea breath test. Statistical analysis was performed with SPSS v21.0 and a p-value < 0.05 was considered statistically significant.Results: Included 60 patients, 39 (65%) female with mean age 52 years (SD ± 14.3). Treatment groups were homogeneous for gender, age, indication for treatment and smoking status. No statistical differences were encountered between sequential and triple therapy eradication rates (86.2% vs 77.4%, p = 0.379), global eradication rate was 82%. Tobacco consumption was associated with a significantly lower eradication success (54.5 vs 87.8%, p = 0.022).Discussion: In this randomized controlled trial in a naive Portuguese population, we found a satisfactory global Helicobacter pylori eradication rate of 82%, with no statistical differences observed in the efficacy of the treatment between triple and sequential regimens.Conclusion: These results support the use of either therapy for the first-line eradication of Helicobacter pylori. |
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Randomized Controlled Trial for Helicobacter pylori Eradication in a Naive Portuguese Population: Is Sequential Treatment Superior to Triple Therapy in Real World Clinical Setting?Ensaio Clínico Randomizado para o Tratamento do Helicobacter pylori em Doentes Portugueses Naive: É o Tratamento Sequencial Superior ao Tratamento Triplo na Prática Clínica?Anti-Bacterial AgentsDrug TherapyCombinationHelicobacter Infections/drug therapyHelicobacter pyloriPortugalStomach NeoplasmsFarmacoterapia CombinadaHelicobacter pyloriInfecções por Helicobacter/tratamentoNeoplasias do EstômagoPortugalIntroduction: Helicobacter pylori eradication has become increasingly difficult as resistances to several antibiotics develop. We aimed to compare Helicobacter pylori eradication rates between triple therapy and sequential therapy in a naive Portuguese population.Material and Methods: Prospective randomized trial including consecutive patients referred for first-line Helicobacter pylori eradication treatment. Exclusion criteria: previous gastric surgery/neoplasia, pregnancy/lactancy, allergy to any of the drugs. The compared eradication regimens were triple therapy (pantoprazol, amoxicillin and clarithromycin 12/12 hours, 14 days) and sequential therapy (pantoprazol 12/12 hours for 10 days, amoxicillin 12/12 hours for days 1 - 5 and clarithromycin plus metronidazol 12/12 hours during days 6 - 10). Eradication success was confirmed with urea breath test. Statistical analysis was performed with SPSS v21.0 and a p-value < 0.05 was considered statistically significant.Results: Included 60 patients, 39 (65%) female with mean age 52 years (SD ± 14.3). Treatment groups were homogeneous for gender, age, indication for treatment and smoking status. No statistical differences were encountered between sequential and triple therapy eradication rates (86.2% vs 77.4%, p = 0.379), global eradication rate was 82%. Tobacco consumption was associated with a significantly lower eradication success (54.5 vs 87.8%, p = 0.022).Discussion: In this randomized controlled trial in a naive Portuguese population, we found a satisfactory global Helicobacter pylori eradication rate of 82%, with no statistical differences observed in the efficacy of the treatment between triple and sequential regimens.Conclusion: These results support the use of either therapy for the first-line eradication of Helicobacter pylori.Introdução: A erradicação do Helicobacter pylori tem adquirido dificuldade progressiva, devido às resistências para os antibióticos utilizados. Pretendemos comparar a eficácia na erradicação do Helicobacter pylori entre o tratamento triplo e sequencial numa população portuguesa naive.Material e Métodos: Trabalho prospectivo randomizado incluindo doentes consecutivos submetidos a primeiro tratamento de erradicação do Helicobacter pylori. Critérios de exclusão: cirurgia/neoplasia gástrica prévias, gravidez/aleitamento, alergia a algum dos fármacos. Os esquemas utilizados foram o tratamento triplo (pantoprazol, amoxicilina claritromicina 12/12 horas, 14 dias) e tratamento sequencial (pantoprazol 12/12 horas durante 10 dias, amoxicilina 12/12 horas nos dias 1 - 5 e claritromicina e metronidazol 12/12 horas nos dias 6 - 10). A eficácia da erradicação foi confirmada com um teste respiratório da ureia. A análise estatística foi efectuada com o SPSS v21.0 e um valor de p < 0,05 foi considerado estatisticamente significativo.Resultados: Incluídos 60 doentes, 39 (65%) mulheres, idade média 52 anos (DP ± 14,3). Os grupos de tratamento foram homogéneos para as variáveis sexo, idade, indicação para tratamento e tabagismo. Não foram observadas diferenças estatisticamente significativas na eficácia de erradicação do Helicobacter pylori entre o tratamento triplo e sequencial (86,2% vs 77,4%, p = 0,379), com uma taxa global de erradicação de 82%. O tabagismo foi associado significativamente a uma menor eficácia de erradicação (54,5 vs 87,8%, p = 0,022).Discussão: Neste ensaio clínico randomizado numa população portuguesa naive, encontrámos uma eficácia global de erradicacão do Helicobacter pylori de 82%, sem diferenças estatisticamente significativas entre o tratamento triplo e o tratamento sequencial.Conclusão: Estes resultados reforçam a possibilidade de utilizar qualquer um destes tratamentos como primeira linha na erradicação do Helicobacter pylori.Ordem dos Médicos2017-03-31info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/mswordapplication/pdfapplication/mswordhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8072oai:ojs.www.actamedicaportuguesa.com:article/8072Acta Médica Portuguesa; Vol. 30 No. 3 (2017): March; 185-189Acta Médica Portuguesa; Vol. 30 N.º 3 (2017): Março; 185-1891646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8072https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8072/4967https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8072/8636https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8072/8696https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8072/8840Direitos de Autor (c) 2017 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessBoal Carvalho, PedroMagalhães, JoanaDias de Castro, FranciscaRosa, BrunoCotter, José2022-12-20T11:05:25Zoai:ojs.www.actamedicaportuguesa.com:article/8072Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:19:32.637009Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Randomized Controlled Trial for Helicobacter pylori Eradication in a Naive Portuguese Population: Is Sequential Treatment Superior to Triple Therapy in Real World Clinical Setting? Ensaio Clínico Randomizado para o Tratamento do Helicobacter pylori em Doentes Portugueses Naive: É o Tratamento Sequencial Superior ao Tratamento Triplo na Prática Clínica? |
title |
Randomized Controlled Trial for Helicobacter pylori Eradication in a Naive Portuguese Population: Is Sequential Treatment Superior to Triple Therapy in Real World Clinical Setting? |
spellingShingle |
Randomized Controlled Trial for Helicobacter pylori Eradication in a Naive Portuguese Population: Is Sequential Treatment Superior to Triple Therapy in Real World Clinical Setting? Boal Carvalho, Pedro Anti-Bacterial Agents Drug Therapy Combination Helicobacter Infections/drug therapy Helicobacter pylori Portugal Stomach Neoplasms Farmacoterapia Combinada Helicobacter pylori Infecções por Helicobacter/tratamento Neoplasias do Estômago Portugal |
title_short |
Randomized Controlled Trial for Helicobacter pylori Eradication in a Naive Portuguese Population: Is Sequential Treatment Superior to Triple Therapy in Real World Clinical Setting? |
title_full |
Randomized Controlled Trial for Helicobacter pylori Eradication in a Naive Portuguese Population: Is Sequential Treatment Superior to Triple Therapy in Real World Clinical Setting? |
title_fullStr |
Randomized Controlled Trial for Helicobacter pylori Eradication in a Naive Portuguese Population: Is Sequential Treatment Superior to Triple Therapy in Real World Clinical Setting? |
title_full_unstemmed |
Randomized Controlled Trial for Helicobacter pylori Eradication in a Naive Portuguese Population: Is Sequential Treatment Superior to Triple Therapy in Real World Clinical Setting? |
title_sort |
Randomized Controlled Trial for Helicobacter pylori Eradication in a Naive Portuguese Population: Is Sequential Treatment Superior to Triple Therapy in Real World Clinical Setting? |
author |
Boal Carvalho, Pedro |
author_facet |
Boal Carvalho, Pedro Magalhães, Joana Dias de Castro, Francisca Rosa, Bruno Cotter, José |
author_role |
author |
author2 |
Magalhães, Joana Dias de Castro, Francisca Rosa, Bruno Cotter, José |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Boal Carvalho, Pedro Magalhães, Joana Dias de Castro, Francisca Rosa, Bruno Cotter, José |
dc.subject.por.fl_str_mv |
Anti-Bacterial Agents Drug Therapy Combination Helicobacter Infections/drug therapy Helicobacter pylori Portugal Stomach Neoplasms Farmacoterapia Combinada Helicobacter pylori Infecções por Helicobacter/tratamento Neoplasias do Estômago Portugal |
topic |
Anti-Bacterial Agents Drug Therapy Combination Helicobacter Infections/drug therapy Helicobacter pylori Portugal Stomach Neoplasms Farmacoterapia Combinada Helicobacter pylori Infecções por Helicobacter/tratamento Neoplasias do Estômago Portugal |
description |
Introduction: Helicobacter pylori eradication has become increasingly difficult as resistances to several antibiotics develop. We aimed to compare Helicobacter pylori eradication rates between triple therapy and sequential therapy in a naive Portuguese population.Material and Methods: Prospective randomized trial including consecutive patients referred for first-line Helicobacter pylori eradication treatment. Exclusion criteria: previous gastric surgery/neoplasia, pregnancy/lactancy, allergy to any of the drugs. The compared eradication regimens were triple therapy (pantoprazol, amoxicillin and clarithromycin 12/12 hours, 14 days) and sequential therapy (pantoprazol 12/12 hours for 10 days, amoxicillin 12/12 hours for days 1 - 5 and clarithromycin plus metronidazol 12/12 hours during days 6 - 10). Eradication success was confirmed with urea breath test. Statistical analysis was performed with SPSS v21.0 and a p-value < 0.05 was considered statistically significant.Results: Included 60 patients, 39 (65%) female with mean age 52 years (SD ± 14.3). Treatment groups were homogeneous for gender, age, indication for treatment and smoking status. No statistical differences were encountered between sequential and triple therapy eradication rates (86.2% vs 77.4%, p = 0.379), global eradication rate was 82%. Tobacco consumption was associated with a significantly lower eradication success (54.5 vs 87.8%, p = 0.022).Discussion: In this randomized controlled trial in a naive Portuguese population, we found a satisfactory global Helicobacter pylori eradication rate of 82%, with no statistical differences observed in the efficacy of the treatment between triple and sequential regimens.Conclusion: These results support the use of either therapy for the first-line eradication of Helicobacter pylori. |
publishDate |
2017 |
dc.date.none.fl_str_mv |
2017-03-31 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8072 oai:ojs.www.actamedicaportuguesa.com:article/8072 |
url |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8072 |
identifier_str_mv |
oai:ojs.www.actamedicaportuguesa.com:article/8072 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8072 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8072/4967 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8072/8636 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8072/8696 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8072/8840 |
dc.rights.driver.fl_str_mv |
Direitos de Autor (c) 2017 Acta Médica Portuguesa info:eu-repo/semantics/openAccess |
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Direitos de Autor (c) 2017 Acta Médica Portuguesa |
eu_rights_str_mv |
openAccess |
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application/pdf application/msword application/pdf application/msword |
dc.publisher.none.fl_str_mv |
Ordem dos Médicos |
publisher.none.fl_str_mv |
Ordem dos Médicos |
dc.source.none.fl_str_mv |
Acta Médica Portuguesa; Vol. 30 No. 3 (2017): March; 185-189 Acta Médica Portuguesa; Vol. 30 N.º 3 (2017): Março; 185-189 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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