Kim Sung Eun, Roh Ji Hun, Park Moo In, Park Seun Ja, Moon Won, Kim Jae Hyun, Jung Kyoungwon, Heo Jae Joon
Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
Department of Internal Medicine, Dong-eui Medical Center, Busan, Korea.
Korean J Gastroenterol. 2019 Jan 25;73(1):26-34. doi: 10.4166/kjg.2019.73.1.26.
BACKGROUND/AIMS: Both bismuth-containing quadruple therapy and moxifloxacin-containing triple therapy have been suggested as second-line eradication therapy for () infection. We aimed to evaluate the efficacy of 14-day moxifloxacin-containing triple therapy (14-EAM) in second-line eradication in comparison to 7-day bismuth-containing quadruple therapy (7-RBMT).
From January 2011 to December 2015, a total of 569 patients who failed to respond to first-line triple therapy and who subsequently received second-line 7-RBMT or 14-EAM were retrospectively enrolled. The eradication rates were identified using per-protocol (PP) analysis. eradication was confirmed by a ¹³C-urea breath test (UBiT-IR300; Otsuka Electronics, Co., Ltd., Osaka, Japan) or a rapid urease test (CLOtest Delta West, Bentley, Australia) at least 4 weeks after completion of eradication therapy.
A total of 487 and 82 patients received 7-RBMT and 14-EAM, respectively. PP eradication rates were 93.6% (366/391; 95% CI, 91.0-95.9%) with 7-RBMT and 73.8% (48/65; 95% CI, 63.1-84.6%) with14-EAM (p<0.001). Therefore, the eradication rates with 7-RBMT were significantly higher than with 14-EAM according to the PP analysis. The adverse event rate was 17.1% (67/391) with 7-RBMT and 7.7% (5/65) with 14-EAM (p=0.065). In terms of risk factors, multivariate analysis revealed that 14-EAM (OR, 5.47; 95% CI, 2.74-10.93) was related to eradication failure.
7-RBMT may be an effective second-line therapy in patients who failed to respond to first-line triple therapy in Korea, where there is a high prevalence of infection.
背景/目的：含铋四联疗法和含莫西沙星三联疗法均被推荐作为（）感染的二线根除治疗方案。我们旨在评估14天含莫西沙星三联疗法（14-EAM）与7天含铋四联疗法（7-RBMT）相比，在二线根除治疗中的疗效。
回顾性纳入2011年1月至2015年12月期间，一线三联疗法治疗失败后接受二线7-RBMT或14-EAM治疗的569例患者。采用符合方案（PP）分析确定根除率。根除治疗完成至少4周后，通过¹³C-尿素呼气试验（UBiT-IR300；日本大阪大冢电子有限公司）或快速尿素酶试验（CLOtest Delta West，澳大利亚本特利）确认根除情况。
分别有487例和82例患者接受了7-RBMT和14-EAM治疗。7-RBMT的PP根除率为93.6%（366/391；95%CI，91.0-95.9%），14-EAM的PP根除率为73.8%（48/65；95%CI，63.1-84.6%）（p<0.001）。因此，根据PP分析，7-RBMT的根除率显著高于14-EAM。7-RBMT的不良事件发生率为17.1%（67/391），14-EAM的不良事件发生率为7.7%（5/65）（p=0.065）。在危险因素方面，多因素分析显示14-EAM（比值比，5.47；95%CI，2.74-10.93）与根除失败有关。
在韩国这种（）感染患病率较高的国家，7-RBMT可能是一线三联疗法治疗失败患者有效的二线治疗方案。
