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A Potassium-Competitive Acid Blocker-Based Regimen as Second-Line Therapy Improves Helicobacter pylori Eradication.
Nabeta, Haruaki; Shinozaki, Satoshi; Abe, Yasuhiro; Koyanagi, Ryota; Nakamichi, Taro; Kobayashi, Yasutoshi; Lefor, Alan Kawarai; Hirashima, Hayato.
Afiliación
  • Nabeta H; Department of Gastroenterology, Utsunomiya Memorial Hospital, Utsunomiya, Japan.
  • Shinozaki S; Shinozaki Medical Clinic, Utsunomiya, Japan, shinozaki-s@aqua.ocn.ne.jp.
  • Abe Y; Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke, Japan, shinozaki-s@aqua.ocn.ne.jp.
  • Koyanagi R; Department of Gastroenterology, Utsunomiya Memorial Hospital, Utsunomiya, Japan.
  • Nakamichi T; Department of Gastroenterology, Utsunomiya Memorial Hospital, Utsunomiya, Japan.
  • Kobayashi Y; Department of Gastroenterology, Utsunomiya Memorial Hospital, Utsunomiya, Japan.
  • Lefor AK; Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke, Japan.
  • Hirashima H; Department of Surgery, Jichi Medical University, Shimotsuke, Japan.
Digestion ; 101(3): 332-338, 2020.
Article en En | MEDLINE | ID: mdl-30991394
BACKGROUND/AIMS: Although a potassium-competitive acid blocker (PCAB)-based regimen improves the rate of successful Helicobacter pylori first-line eradication, the efficacy of a PCAB-based regimen as second-line therapy is unclear. The aim of this study is to compare the success of second-line eradication of H. pylori using PCAB and proton pump inhibitor (PPI)-based regimens. METHODS: From 2014 to 2017, 624 patients who underwent second-line H. pylori eradication were enrolled. A standard triple regimen for second-line H. pylori eradication includes metronidazole 250 mg, amoxicillin 750 mg, and PPI or PCAB twice daily for 7 days. The success of eradication was compared using intention-to-treat, per-protocol, and propensity-score matching analysis. RESULTS: All patients completed the 7-day course of therapy. Patients using a PCAB-based regimen had a higher rate of eradication than those using a PPI-based regimen in both intention-to-treat (90% [298/330] vs. 85% [250/294], p = 0.045) and per-protocol analyses (96% [298/309] vs. 91% [250/274], p = 0.008). Adverse events occurred in 4 patients. Propensity score matching analysis acquired 274 matched pairs. Patients using a PCAB-based regimen had a higher rate of eradication than those using a PPI-based regimen (96% [264/274] vs. 91% [250/274], p = 0.013). CONCLUSIONS: PCAB-based second-line H. pylori eradication is significantly better than PPI-based therapy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Helicobacter pylori / Infecciones por Helicobacter / Inhibidores de la Bomba de Protones / Antiácidos / Antibacterianos Tipo de estudio: Diagnostic_studies / Guideline / Observational_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Digestion Año: 2020 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Helicobacter pylori / Infecciones por Helicobacter / Inhibidores de la Bomba de Protones / Antiácidos / Antibacterianos Tipo de estudio: Diagnostic_studies / Guideline / Observational_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Digestion Año: 2020 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Suiza