Efficacy of three‐in‐one capsule bismuth quadruple therapy for <i>Helicobacter pylori</i> eradication in clinical practice in a multinational patient population

Miehlke, Stephan; Frederking, Dorothea; Günther, Thomas; Glocker, Erik; Eisele, Bianca; Andresen, Viola; Schröder, S.; Morgner, Andrea

doi:10.1111/hel.12429

Cited by 13 publications

(18 citation statements)

References 30 publications

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“…In our study, H. pylori eradication rates were 91% and 97% in first‐line, 87% and 89% in second‐line, 91.7% and 95.6% in third‐line treatment by ITT and PP analysis, respectively. These results are consistent with previous studies in clinical practice, in Italy, Germany, and Spain, which used the same pharmacological formulation of BQT, but in smaller samples of patients. However, some studies reported a slightly lower eradication rate in third‐line treatment.…”

Section: Discussionsupporting

confidence: 92%

“…Patient's compliance is an issue in the treatment of H. pylori infection because of the complexity of the antimicrobial regimens. In our study, a poor compliance negatively affected the outcome of the three‐in‐one BQT, as also reported by previous reports . However, almost all patients treated with the three‐in‐one BQT had a good compliance.…”

Section: Discussionsupporting

confidence: 88%

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The “three‐in‐one” formulation of bismuth quadruple therapy for Helicobacter pylori eradication with or without probiotics supplementation: Efficacy and safety in daily clinical practice

et al. 2018

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 88%

The “three‐in‐one” formulation of bismuth quadruple therapy for Helicobacter pylori eradication with or without probiotics supplementation: Efficacy and safety in daily clinical practice

et al. 2018

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“…In nine studies, information was provided on the proportion of patients with bacterial antibiotic resistance, either to clarithromycin or metronidazole. Such information could not be used in the study by Miehlke 2017 as the efficacy of Pylera ® in this subgroup of patients was not reported. In the forest plots obtained from the remaining studies (Figure A,B), the single capsule had a significant curative effect on H pylori infection, despite the clarithromycin and metronidazole resistance.…”

Section: Resultsmentioning

confidence: 99%

“…In almost 3% of the cases, treatment was discontinued due to AEs. [16][17][18]27,[30][31][32]34,35,37,38,[42][43][44][45]47…”

Section: Safety Of Pylera ®mentioning

confidence: 99%

Meta‐analysis of three‐in‐one single capsule bismuth‐containing quadruple therapy for the eradication of Helicobacter pylori

2019

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Background Bismuth‐containing quadruple therapy has been suggested as first‐line and rescue alternative for Helicobacter pylori eradication. Our objective was to perform a meta‐analysis evaluating the efficacy and safety of single capsule Pylera® (bismuth, metronidazole, and tetracycline) plus a proton‐pump inhibitor (PPI) in any line of treatment. Methods Studies were selected up to October 2018. Outcomes were eradication and adverse events (AEs) rates pooled using the generic inverse variance method. Results In total, 30 studies (6482 patients) were included in the systematic review. The intention‐to‐treat (ITT) efficacy was 90% (95% CI: 87%‐92%, 21 studies, I2 = 88%) in first‐line therapy, 89% (95% CI: 86%‐93%, 12 studies, I2 = 78%) in second‐line and 82% (95% CI: 78%‐87%, nine studies, I2 = 60%) in third‐line; with no differences by the type or dosage of PPI used. For metronidazole‐resistant infection, the ITT efficacy as first‐line therapy was 93% (95% CI: 90%‐96%, six studies, I2 = 0%). In second‐line therapies where patients had been previously treated with clarithromycin, the ITT efficacy was 90% (95% CI: 87%‐93%, 11 studies, I2 = 78%). The overall incidence of AEs was 43% (95% CI: 35%‐50%, 24 studies, I2 = 92%) and they were mostly mild. In nearly 3% of the cases, treatment was interrupted due to AEs. Conclusions A 10‐day treatment with Pylera® achieved an effective eradication rate of approximately 90% both in first‐ and second‐line therapy. This applies regardless of the type and dose of the PPI, in patients with clarithromycin‐ or metronidazole‐resistant strains, and in those previously treated with clarithromycin.

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“…Sequential therapy remains in use in areas of high resistance, but may prove challenging in terms of compliance, and is no longer recommended . Three‐in‐one formulations of bismuth quadruple therapy (BQT) may improve compliance . Probiotics appear to have some effect on H. pylori eradication, as their addition likely improves compliance by reducing the side effects of antibiotics .…”

Section: Introductionmentioning

confidence: 99%

Treatment of Helicobacter pylori infection in 2018

et al. 2018

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Treatment options for the eradication of Helicobacter pylori continue to evolve. There have been many guidelines for H. pylori treatment published, which may lead to some confusion. However, most are in agreement with the most recent iteration of the Maastricht treatment guidelines. Triple therapy is still the most frequently used treatment, especially in areas of low clarithromycin resistance. Its best results are achieved when taken for a minimum of 10 days and with high-dose acid suppression. Quadruple therapy is gaining in popularity particularly in areas with increasing resistance to standard triple therapy. Whether three antibiotics, or bismuth and two antibiotics are used, excellent eradication rates are achieved, albeit with increased side effects. Levofloxacin second-line therapy is widely used; however bismuth, when available, is an increasingly successful option. Sequential therapy is challenging in terms of compliance and is no longer recommended. This past year witnessed a notable increase in the number of studies based on antimicrobial susceptibility testing and tailored eradication therapy, reflecting the role of culture-guided treatment, which may well represent the future of H. pylori treatment and prevent the inappropriate use of antibiotics.

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Efficacy of three‐in‐one capsule bismuth quadruple therapy for Helicobacter pylori eradication in clinical practice in a multinational patient population

Abstract: Three-in-one capsule bismuth quadruple therapy is effective and safe for treatment of H. pylori infection in routine practice, irrespective of the patient's migrational background or the number of previous treatment failures.

Cited by 13 publications

References 30 publications

The “three‐in‐one” formulation of bismuth quadruple therapy for Helicobacter pylori eradication with or without probiotics supplementation: Efficacy and safety in daily clinical practice

The “three‐in‐one” formulation of bismuth quadruple therapy for Helicobacter pylori eradication with or without probiotics supplementation: Efficacy and safety in daily clinical practice

Meta‐analysis of three‐in‐one single capsule bismuth‐containing quadruple therapy for the eradication of Helicobacter pylori

Treatment of Helicobacter pylori infection in 2018

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