Nishizawa Toshihiro, Suzuki Hidekazu, Fujimoto Ai, Kinoshita Hiroto, Yoshida Shuntaro, Isomura Yoshihiro, Toyoshima Akira, Kanai Takanori, Yahagi Naohisa, Toyoshima Osamu
Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo 157-0066, Japan.
Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan.
J Clin Biochem Nutr. 2017 May;60(3):208-210. doi: 10.3164/jcbn.16-86. Epub 2017 Feb 16.
The effects of patient age on the efficacy of eradication treatment for () remain unclear. The present study aimed to determine whether age affects eradication therapy involving vonoprazan, a novel potassium-competitive acid blocker (PCAB). We reviewed the cases of 3,261 patients who were administered first-line and second-line eradication therapy at Toyoshima Endoscopy Clinic. The first-line treatment was clarithromycin and amoxicillin combined with a proton pump inhibitor (PPI) or a PCAB. The second-line treatment was metronidazole and amoxicillin combined with a PPI or PCAB. The patients were divided into a young to middle-aged group (age ≤50 years) and an older group (age >50 years) as well as into PPI and PCAB groups. The PPI-clarithromycin-amoxicillin regimen demonstrated a significantly lower eradication rate than the PCAB-clarithromycin-amoxicillin regimen (<0.001). With the PPI-clarithromycin-amoxicillin regimen, the eradication rate in the young to middle-aged group was significantly lower than that in the older group (<0.001). Lastly, age had no impact on the eradication rate of PCAB-based therapy or metronidazole-based therapy. In conclusion, with clarithromycin-based triple therapy, PCAB is a better choice of antisecretory agent compared to PPIs, especially in young to middle-aged patients.
患者年龄对（）根除治疗疗效的影响尚不清楚。本研究旨在确定年龄是否会影响使用新型钾离子竞争性酸阻滞剂（PCAB）沃克沙唑的根除治疗。我们回顾了丰岛内镜诊所3261例接受一线和二线根除治疗患者的病例。一线治疗为克拉霉素和阿莫西林联合质子泵抑制剂（PPI）或PCAB。二线治疗为甲硝唑和阿莫西林联合PPI或PCAB。患者被分为年轻至中年组（年龄≤50岁）和老年组（年龄>50岁），以及PPI组和PCAB组。PPI-克拉霉素-阿莫西林方案的根除率显著低于PCAB-克拉霉素-阿莫西林方案（<0.001）。使用PPI-克拉霉素-阿莫西林方案时，年轻至中年组的根除率显著低于老年组（<0.001）。最后，年龄对基于PCAB的治疗或基于甲硝唑的治疗的根除率没有影响。总之，在基于克拉霉素的三联疗法中，与PPI相比，PCAB是更好的抑酸剂选择，尤其是在年轻至中年患者中。
