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Article: Ten day sequential versus 10 day modified bismuth quadruple therapy as empirical firstline and secondline treatment for Helicobacter pylori in Chinese patients: an open label, randomised, crossover trial

TitleTen day sequential versus 10 day modified bismuth quadruple therapy as empirical firstline and secondline treatment for Helicobacter pylori in Chinese patients: an open label, randomised, crossover trial
Authors
Issue Date2013
Citation
Gut, 2013 How to Cite?
AbstractOBJECTIVE: Treatments with sequential therapy (SEQ) or bismuth quadruple (QUAD) therapy have been proposed as empirical firstline regimens for Helicobacter pylori. We compared the efficacy and tolerability of 10 day SEQ with 10 day modified QUAD as both firstline and secondline treatments for H pylori in a randomised crossover study. DESIGN: H pylori positive and treatment naive patients were randomly assigned to receive either 10 day SEQ (esomeprazole for 10 days, amoxicillin for an initial 5 days, followed by clarithromycin and metronidazole for a subsequent 5 days) or modified QUAD (esomeprazole, bismuth subcitrate, tetracycline and metronidazole). H pylori eradication was confirmed by urea breath test at 8 weeks. Patients who failed the initial assigned treatment were crossed over to receive the alternate regimen. The primary outcome was eradication rates of firstline treatment by intention to treat (ITT) and per protocol (PP) analyses. RESULTS: 357 patients were randomised to receive either SEQ or QUAD. The PP eradication rates of the SEQ and QUAD groups were 95.2% and 98.8%, respectively (p=0.10). Based on ITT analysis, the corresponding eradication rates were 89.4% and 92.7%, respectively (p=0.36). Eight (4.8%) patients in the SEQ and two (1.2%) patients in the QUAD who failed the firstline treatment were crossed over to the alternate regimen with 100% retreatment success. The overall incidence of adverse events was higher in the QUAD (16.7%) than in the SEQ (8.1%; p=0.032) group. CONCLUSIONS: Ten day sequential and modified bismuth quadruple therapies are both highly effective as empirical firstline therapies for H pylori in Chinese patients. CLINICALTRIALS.GOV: NCT 01760824.
Persistent Identifierhttp://hdl.handle.net/10722/193877
ISSN
2015 Impact Factor: 14.921
2015 SCImago Journal Rankings: 6.474
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLiu, KSen_US
dc.contributor.authorHung, IFNen_US
dc.contributor.authorSeto, WKWen_US
dc.contributor.authorTong, Ten_US
dc.contributor.authorHsu, ASJen_US
dc.contributor.authorLam, FYen_US
dc.contributor.authorBut, YKDen_US
dc.contributor.authorWong, SYen_US
dc.contributor.authorLeung, WKen_US
dc.date.accessioned2014-01-28T06:30:45Z-
dc.date.available2014-01-28T06:30:45Z-
dc.date.issued2013en_US
dc.identifier.citationGut, 2013en_US
dc.identifier.issn0017-5749en_US
dc.identifier.urihttp://hdl.handle.net/10722/193877-
dc.description.abstractOBJECTIVE: Treatments with sequential therapy (SEQ) or bismuth quadruple (QUAD) therapy have been proposed as empirical firstline regimens for Helicobacter pylori. We compared the efficacy and tolerability of 10 day SEQ with 10 day modified QUAD as both firstline and secondline treatments for H pylori in a randomised crossover study. DESIGN: H pylori positive and treatment naive patients were randomly assigned to receive either 10 day SEQ (esomeprazole for 10 days, amoxicillin for an initial 5 days, followed by clarithromycin and metronidazole for a subsequent 5 days) or modified QUAD (esomeprazole, bismuth subcitrate, tetracycline and metronidazole). H pylori eradication was confirmed by urea breath test at 8 weeks. Patients who failed the initial assigned treatment were crossed over to receive the alternate regimen. The primary outcome was eradication rates of firstline treatment by intention to treat (ITT) and per protocol (PP) analyses. RESULTS: 357 patients were randomised to receive either SEQ or QUAD. The PP eradication rates of the SEQ and QUAD groups were 95.2% and 98.8%, respectively (p=0.10). Based on ITT analysis, the corresponding eradication rates were 89.4% and 92.7%, respectively (p=0.36). Eight (4.8%) patients in the SEQ and two (1.2%) patients in the QUAD who failed the firstline treatment were crossed over to the alternate regimen with 100% retreatment success. The overall incidence of adverse events was higher in the QUAD (16.7%) than in the SEQ (8.1%; p=0.032) group. CONCLUSIONS: Ten day sequential and modified bismuth quadruple therapies are both highly effective as empirical firstline therapies for H pylori in Chinese patients. CLINICALTRIALS.GOV: NCT 01760824.en_US
dc.languageengen_US
dc.relation.ispartofGuten_US
dc.titleTen day sequential versus 10 day modified bismuth quadruple therapy as empirical firstline and secondline treatment for Helicobacter pylori in Chinese patients: an open label, randomised, crossover trialen_US
dc.typeArticleen_US
dc.identifier.emailHung, IFN: ivanhung@hkucc.hku.hken_US
dc.identifier.emailSeto, WKW: wkseto2@hku.hken_US
dc.identifier.emailHsu, ASJ: axelhsu@hku.hken_US
dc.identifier.emailBut, YKD: drdbut@hku.hken_US
dc.identifier.emailWong, SY: ksywong@hkucc.hku.hken_US
dc.identifier.emailLeung, WK: hku75407@hku.hken_US
dc.identifier.authorityHung, IFN=rp00508en_US
dc.identifier.authoritySeto, WKW=rp01659en_US
dc.identifier.authorityLeung, WK=rp01479en_US
dc.identifier.doi10.1136/gutjnl-2013-306120en_US
dc.identifier.pmid24295850-
dc.identifier.hkuros227483en_US
dc.identifier.isiWOS:000341014600012-

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