A comparison between standard triple therapy and sequential therapy on eradication of Helicobacter pylori in uremic patients: A randomized clinical trial

Makhlough, Atieh; Fakheri, Hafez; Farkhani, Ahmad Ramezani; Hossieni, Seyed Vahid; Khademloo, Mohammad; Bari, Zohreh

doi:10.4103/2277-9175.146372

Cited by 4 publications

(2 citation statements)

References 30 publications

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“…Several studies reported various eradication rates by triple therapy regimens ranging from 72.7% to 94.1% in hemodialysis-dependent patients [ 32 – 35 ]. In the clinical trial by Makhlough et al, the eradication rate of a standard triple therapy in CKD stage 3 was 50% (1/2), in CKD stage 4 was 75% (3/4), and in hemodialysis was 80% (12/15) [ 36 ]. In our study, which included larger case numbers than previous studies on CKD, the eradication rate in CKD stage 3 was 84.5% (82/97), in CKD stage 4 was 88.2% (15/17), and in hemodialysis was 87.5% (14/16).…”

Section: Discussionmentioning

confidence: 99%

First-Line Helicobacter pylori Eradication in Patients with Chronic Kidney Diseases in Taiwan

Liang

Chiu

Wang

et al. 2017

BioMed Research International

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Aims Patients with chronic kidney disease (CKD) and Helicobacter pylori (H. pylori) infection have a higher incidence of gastroduodenal diseases and therefore are recommended to receive eradication therapies. This study aimed to assess the efficacy of a 7-day standard triple therapy in patients with CKD (eGFR < 60 ml/min/1.73 m2) and to investigate the clinical factors influencing the success of eradication. Methods A total of 758 patients with H. pylori infection receiving a 7-day standard first-line triple therapy between January 1, 2013, and December 31, 2014, were recruited. Patients were divided into two groups: CKD group (N = 130) and non-CKD group (N = 628). Results The eradication rates attained by the CKD and non-CKD groups were 85.4% and 85.7%, respectively, in the per-protocol analysis (p = 0.933). The eradication rate in CKD stage 3 was 84.5% (82/97), in stage 4 was 88.2% (15/17), and in those who received hemodialysis was 87.5% (14/16). There were no significant differences in the various stages of CKD (p = 0.982). The adverse events were similar between the two groups (3.1% versus 4.6%, p = 0.433). Compliance between the two groups was good (100.0% versus 99.8%, p = 0.649). There was no significant clinical factor influencing the H. pylori eradication rate in the non-CKD and CKD groups. Conclusions This study suggests that the H. pylori eradication rate and adverse rate in patients with CKD are comparable to those of non-CKD patients.

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Section: Discussionmentioning

confidence: 99%

First-Line Helicobacter pylori Eradication in Patients with Chronic Kidney Diseases in Taiwan

Liang

Chiu

Wang

et al. 2017

BioMed Research International

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“…H.pylori eradication rates were 76.2% and 87.5% by per-protocol analysis, respectively. 12 According to another study by Wang and co-workers on 40 hemodialysis patients, 7-day omeprazole-amoxicillin-clarithromycin(OAC) regimen could eradicate H.pylori in 86.8% of cases. 13 In addition, Tsukada and colleagues reported 82.1% eradication rate using the same regimen for 39 hemodialysis patients.…”

Section: Discussionmentioning

confidence: 99%

A Comparison between Hybrid Therapy and Standard Triple Therapy for Helicobacter pylori Eradication in Patients with Uremia: A Randomized Clinical Trial

Makhlough

Fakheri

Hojati

et al. 2015

Middle East J Dig Dis

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BACKGROUND The prevalence of peptic ulcer disease in hemodialysis patients is more than the general population. They are also more prone to complications including upper gastrointestinal bleeding. The aim of this study was to compare the efficacy of 14 days hybrid regimen with 14 days triple therapy for Helicobacter pylori (H. pylori ) eradication in hemodialysis patients. METHODS Forty hemodialysis patients with naïve H.pylori infection were randomized to receive either hybrid regimen (pantoprazole 40 mg + amoxicillin 500 mg, both twice a day during the first 7 days, followed by pantoprazole 40 mg + amoxicillin 500 mg + clarithromycin 500 mg + tinidazole 500 mg, all twice a day, for the second 7 days, or standard triple therapy including pantoprazole 40 mg, clarithromycin 500 mg, and amoxicillin 500 mg, all twice a day for 14 days. H.pylori eradication was assessed by fecal H.pylori antigen test 8 weeks after the treatment. RESULTS All the patients completed the study. According to both intention to treat and per-protocol analyses, H.pylori eradication rates were 100% (95% confidence interval (CI): 100) in those who received hybrid therapy and 70% (95% CI: 69.4 – 70.8) in those who were treated by standard triple therapy (p=0.02). Severe adverse effects were not reported by any patient; however, mild adverse effects were more frequent in those who received standard triple therapy (p<0.05). CONCLUSION Hybrid regimen could achieve ideal H.pylori eradication rates with low rates of adverse effects.

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Systematic review with meta-analysis: 10- or 14-day sequential therapy vs. 14-day triple therapy in the first line treatment ofHelicobacter pyloriinfection

Liou

Chen

Lee

et al. 2015

Aliment Pharmacol Ther

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Summary Background Whether 10‐day or 14‐day sequential therapy is superior to 14‐day triple therapy in the first‐line treatment of Helicobacter pylori remains controversial. Aim To compare the efficacy of 10‐day or 14‐day sequential therapy vs. 14‐day triple therapy. Methods Randomised controlled trials (RCTs) comparing 10‐day or 14‐day sequential therapy and 14‐day triple therapy as first‐line treatment in adults were searched from the PubMed and Cochrane databases from 2000 to October 2015. Abstracts from international annual conferences were also searched. The primary and secondary outcomes were the eradication rate according to the intention‐to‐treat analysis and adverse effects, respectively. Results Of the 109 articles identified, 13 RCTs including 2749 patients in the sequential therapy group and 2424 patients in the 14‐day triple therapy group were eligible. Overall, sequential therapy for 10 or 14 days was not significantly superior to 14‐day triple therapy [Risk ratio (RR) 1.04, 95% confidence interval (CI) 0.99–1.08, P = 0.145]. However, there was significant heterogeneity (I2 = 57.6%, P = 0.005). In the subgroup analysis of four trials, we found that 14‐day sequential therapy was significantly more effective than 14‐day triple therapy (RR: 1.09, 95% CI: 1.04–1.16, P = 0.002), and there was no significant heterogeneity (I2 = 0%, P = 0.624) in this comparison. Sequential therapy given for 10 days was not superior to 14‐day triple therapy (RR: 1.03, 95% CI: 0.98–1.09, P = 0.207). There was no significant difference in the risk of adverse effects. Conclusion Sequential therapy given for 14 days, but not 10 days, was more effective than 14‐day triple therapy as first‐line treatment.

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A comparison between standard triple therapy and sequential therapy on eradication of Helicobacter pylori in uremic patients: A randomized clinical trial

Cited by 4 publications

References 30 publications

First-Line Helicobacter pylori Eradication in Patients with Chronic Kidney Diseases in Taiwan

First-Line Helicobacter pylori Eradication in Patients with Chronic Kidney Diseases in Taiwan

A Comparison between Hybrid Therapy and Standard Triple Therapy for Helicobacter pylori Eradication in Patients with Uremia: A Randomized Clinical Trial

Systematic review with meta-analysis: 10- or 14-day sequential therapy vs. 14-day triple therapy in the first line treatment ofHelicobacter pyloriinfection

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