Comparative evaluation of two Helicobacter pylori eradication schemes  (with and without bismuth tripotassium dicitrate)

Белковец, А. В.; Курилович, С. А.; ), ); Yurkova, T.A. Yurkova; Tolkacheva, N.Yu. Tolkacheva; Щербакова, Л. В.

doi:10.18565/pharmateca.2019.2.61-67

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“…Исследование выполнено на базе поликлиники КГБУЗ «Городская клиническая поликлиника № 3» г. Хабаровска. Критерии включения в исследование: наличие у пациента инфекции HР и показания к проведению эрадикационной терапии [1]. Критерии исключения: возраст моложе 18 лет и старше 65 лет, наличие аллергии к назначаемым препаратам, беременность, использование антибиотиков в течение 2 месяцев перед исследованием, проведение эрадикационной терапии в анамнезе и наличие тяжелых сопутствующих заболеваний.…”

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“…В современных клинических рекомендациях [1,2,3] отражено важное значение Helicobacter pylori (НР)инфекции в развитии хронического гастрита, язвенной болезни, рака желудка и осложненном течении НПВПгастропатии. Эрадикация НР предотвращает прогрессирование хронического гастрита, снижает риск развития рака желудка, способствует заживлению эрозий и язв желудка и двенадцатиперстной кишки и является необходимой для успешной профилактики осложнений: кровотечения, перфорации.…”

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“…Удлинение сроков лечения до 14 дней способствует повышению эффективности эрадикационной терапии, однако увеличивает стоимость и частоту нежелательных побочных явлений от приема лекарственных препаратов, снижает комплаентность. Минимальная продолжительность эрадикационной терапии в течение 10 дней может быть рекомендована в тех случаях, когда исследования, проведенные в данном регионе, подтвердили ее достаточно высокую эффективность [1].…”

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Сравнительная оценка эффективности 10-дневных схем эрадикации helicobacter pylori инфекции (тройной и тройной с добавлением висмута трикалия дицитрата)

2019

Far East Medical Journal

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The article presents the results of a comparative study of the efficacy and tolerability of two 10-day eradication therapy regimens of Helicobacter pylori (HP) infection (triple and triple with the addition of bismuth tripotassium dicitrate (BTD). The study involved 158 patients with HP-associated pathology (dispepsia, erosive and ulcerative lesions of the gastroduodenal mucosa) from 18 to 65 years of age (mean age=44,6±13,5 years): 57 men (36,1 %), 101 women (63,9 %). The diagnostics of HP-infection performed using a rapid urease test (Helpil test St'Petersburg) in the course fibrogastroduodenoscopy (FGDS). The patients were divided randomly into two groups. In the group 1, 75 patients received classical first-line triple therapy: esomeprazole 20 mg twice a day, amoxicillin 1 000 mg twice a day, clarithromycin 500 mg twice a day. In the group 2, 83 patients received treatment using a similar regimen, but with the addition of BTD 240 mg twice a day. The duration of treatment in both groups was 10 days. The effectiveness of the eradication therapy was evaluated after 6-8 weeks of the end of the treatment course by means of qualitative rapid determination of fecal HP antigens using the method of immunochromatography with monoclonal antibodies (Vegal Farmaceutica, Spain). Out of the 75 patients in group 1, 60 (80 %) showed eradication of HP infection was achieved. Out of 83 patients in group 2, the eradication of HP infection was achieved in 76 patients (92,5 %). The difference in the effectiveness of eradication therapy in patients in group 1 and group 2 is statistically significant (p<0,05). Thus, the classical 10-day regimen of triple antihelicobacter therapy is not effective enough and is not recommended for use in clinical practice in Khabarovsk. A 10-day triple therapy with the addition of BTD is highly effective in the Far Eastern region (Khabarovsk) and recommended as a first-line therapy. A significant reduction in the adverse events frequency in the form of bitter taste in the mouth and diarrhea is an additional advantage of the regimen using bismuth tripotassium dicitrate in comparison with the classical regimen of the triple antihelicobacter therapy.

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Сравнительная оценка эффективности 10-дневных схем эрадикации helicobacter pylori инфекции (тройной и тройной с добавлением висмута трикалия дицитрата)

2019

Far East Medical Journal

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Clinical Practice Guidelines of Russian Gastroenterological Association, Scientific Society for the Clinical Study of Human Microbiome, Russian Society for the Prevention of Non-Communicable Diseases, Interregional Association for Clinical Microbiology and Antimicrobial Chemotherapy for <i>H. pylori</i> Diagnostics and Treatment in Adults

Лапина

Маев

et al. 2022

Rossijskij žurnal gastroènterologii, gepatologii, koloproktolog

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Aim: bring to the attention of practitioners indications for anti-Helicobacter therapy, methods and procedure for diagnostics and eradication therapy of Н. pylori infection.Key points. Chronic gastritis caused by Н. pylori infection, including asymptomatic persons, may be considered as an indication for eradication therapy of Н. pylori as etiological therapy and opportunistic screening for gastric cancer prevention. Indications, for obligatory anti-Helicobacter therapy include peptic ulcer, gastric MALT lymphoma, early gastric cancer (EGC) with endoscopic resection. H. pylori primary diagnostics methods include 13C-urea breath test, H. pylori stool antigen lab test, rapid urease test and serological method. The serological method cannot be used after anti-Helicobacter therapy.In Russia H. pylori strains' resistance to clarithromycin does not exceed 15 % in most regional studies. The first line therapy for Н. pylori infection eradication is the standard triple therapy including a proton pump inhibitor (PPI), clarithromycin and amoxicillin, enhanced with bismuthate tripotassium dicitrate. A classic four-component therapy based on bismuthate tripotassium dicitrate or quadrotherapy without bismuth drug products which includes PPI, amoxicillin, clarithromycin and metronidazole, may be used as alternative to the first line eradication therapy. The standard triple therapy may be prescribed for 14 days only in those regions, where it has been proven to be effective. Quadrotherapy with bismuthate tripotassium dicitrate is also used as main second line therapy in case of standard triple therapy, bismuth enhanced standard triple therapy or combined therapy failure. Another second line therapy includes PPI, levofloxacin and amoxicillin, to which a bismuth-containing drug product may be added. The third line therapy is selected individually based on previously used treatment settings.Conclusion. In each case of H. pylori infection the decision for eradication therapy should be made, which is especially relevant as eradication of H. pylori has been recognized as an effective measure for the prevention of gastric cancer.

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Comparative evaluation of two Helicobacter pylori eradication schemes (with and without bismuth tripotassium dicitrate)

Cited by 2 publications

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Сравнительная оценка эффективности 10-дневных схем эрадикации helicobacter pylori инфекции (тройной и тройной с добавлением висмута трикалия дицитрата)

Сравнительная оценка эффективности 10-дневных схем эрадикации helicobacter pylori инфекции (тройной и тройной с добавлением висмута трикалия дицитрата)

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