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: Carvalho, Pedro Boal
• Data de Publicação: 2017
• Outros Autores: Magalhães, Joana, Castro, Francisca Dias de, Rosa, Bruno, Cotter, José Almeida Berkeley
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/1822/51538
• 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 Estôma; Farmacoterapia Combinada; Infecções por Helicobacter/tratamento; Neoplasias do Estôma; Ciências Médicas::Medicina Clínica; Science & Technology

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.