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Sequential therapy achieves a higher eradication rate than standard triple therapy in Taiwan
Author(s) -
Tsay FengWoei,
Tseng HuiHwa,
Hsu PingI,
Wang KaiMing,
Lee ChingChang,
Chang ShiuhNan,
Wang HuayMin,
Yu HsienChung,
Chen WenChi,
Peng NanJing,
Lai KwokHung,
Wu DengChyang
Publication year - 2012
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2011.06885.x
Subject(s) - medicine , pantoprazole , clarithromycin , rapid urease test , metronidazole , helicobacter pylori , amoxicillin , gastroenterology , adverse effect , urea breath test , pharmacotherapy , intention to treat analysis , surgery , gastritis , antibiotics , omeprazole , helicobacter pylori infection , microbiology and biotechnology , biology
Background and Aims: Most clinical trials concerning sequential therapy have been conducted in Italy. The efficacy of sequential therapy for Helicobacter pylori ( H. pylori ) eradication in Asia remains unclear. The aim of this study was to compare the efficacy of sequential therapy with standard triple therapy in Taiwan. Methods: From January 2005 to December 2009, 233 H. pylori ‐infected patients receiving either a 10‐day sequential therapy (40 mg pantoprazole and 1 g amoxicillin, twice daily, for the initial 5 days, followed by 40 mg pantoprazole, 500 mg clarithromycin, and 500 mg metronidazole, twice daily, for the subsequent 5 days, n = 118) or a 7‐day standard triple therapy (40 mg pantoprazole, 500 mg clarithromycin, and 1 g amoxicillin twice daily for 7 days, n = 115) were included in the retrospective study. All the patients underwent a follow‐up endoscopy with a rapid urease test and histological examination or a urea breath test at 8 weeks after the end of anti‐ H. pylori therapy to assess H. pylori status. Result: Intention‐to‐treat analysis demonstrated a significantly higher eradication rate for the sequential group than for the triple group (93% vs 80%, respectively, P = 0.003). Per‐protocol analysis also showed similar results (93% vs 80%, P = 0.005). Both groups had similar frequencies of adverse events (29% vs 22%) and drug compliance (98% vs 97%). Conclusion: Sequential therapy achieves a higher eradication rate than standard triple therapy in Taiwan. The novel treatment can be used as a first‐line therapy for H. pylori infection for Taiwanese.