Concomitant and hybrid therapy for Helicobacter pylori infection: A randomized clinical trial. Issue 9 (September 2015)

• Record Type: Journal Article
• Authors: Heo, Jun; Jeon, Seong Woo; Jung, Jin Tae; Kwon, Joong Goo; Lee, Dong Wook; Kim, Hyun Soo; Yang, Chang Hun; Park, Jeong Bae; Park, Kyung Sik; Cho, Kwang Bum; Lee, Si Hyung; Jang, Byung Ik; Daegu‐Gyeongbuk Gastrointestinal Study Group
• Is Part Of: Journal of gastroenterology and hepatology. Volume 30:Issue 9(2015:Sep.)
• Page Start: 1361
• Page End: 1366
• Publication Date: 2015-09
• Subjects: Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Liver Diseases -- Periodicals; 616.33
• DOI: 10.1111/jgh.12983
• Languages: English
• ISSNs: 0815-9319

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="jgh12983-sec-0001" sec-type="section"> <title>Background and Aims</title> <p>This study aimed to validate the equivalence of first‐line concomitant and hybrid regimens for <italic>H</italic><italic>elicobacter pylori</italic> infection in an era of increasing antibiotic resistance. The study also aimed to assess regimen compliance.</p> </sec> <sec id="jgh12983-sec-0002" sec-type="section"> <title>Methods</title> <p> <italic>H</italic> <italic>. pylori</italic>‐infected patients from six hospitals in Korea were randomly assigned to either concomitant or hybrid regimens. The concomitant regimen consisted of 20 mg of esomeprazole, 1 g of amoxicillin, 500 mg of clarithromycin, and 500 mg metronidazole, twice daily for 10 days. The hybrid regimen consisted of a 5‐day dual therapy (20 mg of esomeprazole and 1 g of amoxicillin, twice daily) followed by a 5‐day quadruple therapy (20 mg of esomeprazole, 1 g of amoxicillin, 500 mg of clarithromycin, and 500 mg of metronidazole, twice daily).</p> </sec> <sec id="jgh12983-sec-0003" sec-type="section"> <title>Results</title> <p>Eradication rates for concomitant and hybrid therapy were 78.6% (187/238) and 78.8% (190/241) in the intention‐to‐treat analysis, and 89.8% (176/196) and 89.6% (181/202) in the per protocol analysis. For both analyses, 95% confidence intervals fell within the ± 8% equivalence margin. Adherence was better in the hybrid group (95.0%) than in the concomitant group (90.1%), a difference that was borderline significant (<italic>P</italic> = 0.051). Adverse event rates were higher in the concomitant group than in the hybrid group for nausea (15.8% <italic>vs</italic> 8.8%; <italic>P</italic> = 0.028) and regurgitation (17.6% <italic>vs</italic> 10.7%; <italic>P</italic> = 0.040).</p> </sec> <sec id="jgh12983-sec-0004" sec-type="section"> <title>Conclusion</title> <p>As compared with concomitant therapy, hybrid therapy offered similar efficacy, better compliance, and fewer adverse events. Hybrid therapy could be a reasonable first‐line treatment option for <italic>H</italic><italic>. pylori</italic> in areas with high antibiotics resistance.</p> </sec> </abstract>