High Eradication Rates of Helicobacter pylori Infection Following Sequential Therapy: The Israeli Experience Treating Naïve Patients

Schmiloviz-Weiss, Hemda; Shalev, Tamar; Chechoulin, Yelena; Levi, Zohar; Ron, Yishai; Sehayek-Shabbat, Vered; Niv, Yaron; Shirin, Haim

doi:10.1111/j.1523-5378.2011.00834.x

Cited by 18 publications

(11 citation statements)

References 30 publications

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“…La terapia secuencial ofrece buenas tasas de curación, por encima del 90% 13 , en concordancia con lo encontrado en 3 ensayos clínicos incluidos en la presente revisión, en los que se utiliza como terapia de primera línea, realizados en Israel, Taiwán e Italia, logrando tasas eficaces de erradicación por ITT excelentes y buenas respectivamente en los 2 últimos países 53,56,61 . Similares resultados han sido reportados en las revisiones sistemáticas realizadas por Moayyedi 72 , Jafri et al 73 y Grigorios et al 74 .…”

Section: Discussionunclassified

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Tratamiento ideal del Helicobacter pylori: una revisión sistemática

Sierra

Forero

Rey

2014

Revista de Gastroenterología de México

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Section: Discussionunclassified

“…La cuádruple terapia con bismuto por 7 días de duración en ITT fue eficaz en un 87.5% 52 , y la terapia secuencial de 10 días de tratamiento fue eficaz en el análisis PP en el 95.8% (115/124), y por ITT, en el 92.7% (115/120) 53 .…”

Section: Ensayos Clínicos No Aleatorizadosunclassified

Tratamiento ideal del Helicobacter pylori: una revisión sistemática

Sierra

Forero

Rey

2014

Revista de Gastroenterología de México

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“…Other studies carried out in various parts of the world showed very promising results for sequential therapy. In Israel, the 10-day sequential therapy gave an eradication rate of 95.8% by per-protocol analysis and 92.7% by intention-to-treat analysis [9]. A dedicated study of sequential therapy as a second-line regime was also carried out in Taiwan and revealed excellent eradication rates of 95.1% [10].…”

Section: Triple Therapymentioning

confidence: 99%

Treatment of Helicobacter pylori infection 2012

et al. 2012

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Helicobacter pylori resistance rates to antibiotics vary in different countries and even in different regions of the same country. Choice of treatment is strongly dependent on antibiotic resistance rates. In some countries, triple therapy with a proton-pump inhibitor, amoxicillin, and clarithromycin is still the best option, but eradication results fall short of what would be desired (90-95%) in countries with clarithromycin resistance >20%, bismuth-containing quadruple therapy, or nonbismuth sequential or concomitant therapies may then be the preferred option. Newer antibiotic regimens are awaited. Vaccination would be the best option, especially for developing countries, but little progress has been made in designing a vaccine.A considerable amount of work has been conducted over the last year assessing many issues around Helicobacter pylori eradication therapy. These focussed primarily on assessing the efficacy of current standard triple therapy and exploring new first-line treatments. There was also progress in investigating antibiotic resistance rates, and the rescue therapies required to deal with ensuing treatment failures. There has also been an evolution in the use of adjunctive therapies. This article will address the published literature over the last year pertaining to these topics. Triple TherapyNumerous studies over the last year have assessed the efficacy of standard triple therapy with amoxicillin, clarithromycin, and a proton-pump inhibitor for the eradication of H. pylori, which have been perceived to be in decline in recent years. One such study looked at cure rates reported in all published literature from Spain between 1997 and 2008 and found that while cure rates have in fact been stable over that period, they remain inadequate with a mean cure rate of 80% by intention-to-treat and 83% by per-protocol [1]. Similar results were obtained from a multicenter study in Japan that revealed an eradication rate of 80.7% with an incidence of adverse drug reactions of 4.4% [2]. Other studies have looked at whether the efficacy of triple therapy can be improved by prolonging the course of therapy. In China, a study of shorter regimens showed eradication rates of 76, 89, and 91% for 3-day, 5-day, and 7-day regimens, respectively [3]. Increasing efficacy by prolongation of therapy was also noted in Greek patients, with eradication rates of 74.5% for 7 days, 80.6% for 10 days, and 90.2% for 14 days of therapy [4]. Another study showed that efficacy could be maintained when lower doses of medications were given, which reduced costs and side effects with cure rates of 77.2% for 10 mg rabeprazole, 500 mg amoxicillin, and 250 mg clarithromycin vs 78.9% for the standard 20 mg, 1 g, and 500 mg doses of these drugs [5].Regardless of the type of therapy used, study from Canada showed widespread failure to comply with test and treat in up to 10% of cases and a failure to confirm eradication in 32% [6]. This illustrates that efficacious first-line therapy will always depend on adherence to guidelines by phy...

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“…When considering only data from studies published in the last 5 years, the cure rate following sequential therapy was still 90-92.6% in 5 Italian studies with more than 1000 patients [26,38-41], and 73% in another study with 100 cases [42]. A similarly high success rate of sequential therapy has been observed in studies recently performed in Slovenia (94.2%) [43], Portugal (90%) [44], Belgium (90%) [3], Israel (95.9%) [45], Thailand (94%) [46], Taiwan (91.9%) [47], Singapore (90.3%) [48], and the United Arab Emirates (88.6%) [49], suggesting that this therapy is still effective in several countries. Based on these findings, Italian, Slovenian, or Portuguese physicians could inopportunely deprive their patients a priori of a still effective therapy by following the European guidelines.…”

Section: Bismuth-free Therapiesmentioning

confidence: 85%

First-line therapies for Helicobacter pylori eradication: a critical reappraisal of updated guidelines

Francesco¹,

Bellesia²,

Manta

et al. 2017

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Helicobacter pylori (H. pylori) treatment remains a challenge for the clinician, as no available therapy is able to cure the infection in all treated patients. In the last two decades, several antibiotic combinations have been proposed, including triple therapies, bismuth-free therapies (sequential, concomitant, hybrid regimens), and bismuth-based quadruple therapy. Some national and international guidelines on H. pylori management have recently been updated, recommending or discouraging the use of each of these therapeutic approaches, based mainly on the presumed pattern of primary antibiotic resistance in different geographic areas. We examined the recommendations on first-line therapies in the most recently updated guidelines worldwide, taking into account other data affecting the efficacy of a therapy regimen beyond the primary resistance pattern. Although several guidelines highlighted that the results achieved by an eradication therapy are population-specific and not directly transferable, it emerged that some therapy regimens are recommended or discouraged with no mention of the vital need for national data.

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High Eradication Rates of Helicobacter pylori Infection Following Sequential Therapy: The Israeli Experience Treating Naïve Patients

Abstract: The sequential regimen attained significantly higher eradication rates in naïve patients than usually reported for conventional triple therapy. Sequential therapy may be an alternative first-line therapy in eradicating H. pylori in Israel.

Cited by 18 publications

References 30 publications

Tratamiento ideal del Helicobacter pylori: una revisión sistemática

Tratamiento ideal del Helicobacter pylori: una revisión sistemática

Treatment of Helicobacter pylori infection 2012

First-line therapies for Helicobacter pylori eradication: a critical reappraisal of updated guidelines

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