Comparison of tailored eradication versus modified bismuth quadruple therapy in Korea: a randomized controlled trial.

Objectives: We aimed to compare the success rate, adverse drug events, and cost-effectiveness of tailored Helicobacter pylori eradication and modified bismuth-containing quadruple therapy.Methods: The diagnosis of H. pylori infection was randomly based on either rapid urease test (RUT) or dual primi...

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Publicado en:Expert Review of Anti-infective Therapy Vol. 20; no. 6; pp. 923 - 930
Autores principales: Cho, Jun-Hyung, Jin, So Young, Park, Suyeon
Formato: research randomized controlled trial Journal Article
Publicado: Taylor & Francis Ltd Jun2022
Acceso en línea:Ver este registro en EBSCOhost
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        14787210
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      dt: Jun2022
      vid: 20
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      pub: Taylor & Francis Ltd
      place: Philadelphia, Pennsylvania
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        157107924
        157107924
        NLM34883037
        157107924
        10.1080/14787210.2022.2017280
        NLM34883037
        157107924
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        atl: Comparison of tailored eradication versus modified bismuth quadruple therapy in Korea: a randomized controlled trial.
      aug:
        au:
          Cho, Jun-Hyung
          Jin, So Young
          Park, Suyeon
        affil: Digestive Disease Center, Soonchunhyang University Hospital, Seoul, Korea
      sug:
        subj:
          Helicobacter Infections Drug Therapy
          Helicobacter Pylori
          Treatment Outcomes
          Clarithromycin Therapeutic Use
          Metronidazole
          South Korea
          Bismuth
          Drug Therapy, Combination
          Human
          Amoxicillin
          Antibiotics Adverse Effects
          Comparative Studies
          Multicenter Studies
          Randomized Controlled Trials
          Evaluation Research
          Validation Studies
          Scales
      ab: Objectives: We aimed to compare the success rate, adverse drug events, and cost-effectiveness of tailored Helicobacter pylori eradication and modified bismuth-containing quadruple therapy.Methods: The diagnosis of H. pylori infection was randomly based on either rapid urease test (RUT) or dual priming oligonucleotide (DPO)-based multiplex polymerase chain reaction (PCR) in 1:1 ratio. According to the presence of point mutations that cause clarithromycin resistance, patients in the tailored therapy (TT) group received standard triple therapy or classic bismuth quadruple therapy. Patients with positive RUT results received 40 mg pantoprazole, 1000 mg amoxicillin, 750 mg metronidazole, and 600 mg bismuth subcitrate twice daily for 14 days (PAM-B therapy).Results: Between the TT (n = 141) and PAM-B groups (n = 141), H. pylori eradication rate did not differ significantly according to intention-to-treat (TT: 80.9% vs. PAM-B: 85.8%, P = 0.262), modified intention-to-treat (TT: 89.1% vs. PAM-B: 91.0%, P = 0.606), and per-protocol (TT: 89.0% vs. PAM-B: 93.5%, P = 0.198) analyses. The average cost for successful eradication was higher in the TT group than in the PAM-B group ($340.7 vs. $263.9 per patient).Conclusion: PAM-B therapy exhibits similar efficacy and improved cost-effectiveness compared to TT based on the results of DPO-PCR tests.Clinical Trial Registration: www.clinicaltrials.gov identifier is NCT05002595.
      pubtype: Academic Journal
      doctype:
        research
        randomized controlled trial
        Journal Article
      ougenre: Article
    language: English
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