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高剂量艾拉普拉唑-阿莫西林双联疗法作为海南地区幽门螺杆菌感染一线治疗的疗效:一项单中心、开放标签、非劣效、随机对照临床试验。

Ilaprazole-amoxicillin dual therapy at high dose as a first-line treatment for helicobacter pylori infection in Hainan: a single-center, open-label, noninferiority, randomized controlled trial.

机构信息

Graduate School, Hainan Medical University, Haikou, China.

Department of Gastroenterology, The Second Affiliated Hospital of Hainan Medical University, Yehai Avenue, #368, Longhua District, Haikou, Hainan Province, China.

出版信息

BMC Gastroenterol. 2023 Jul 24;23(1):249. doi: 10.1186/s12876-023-02890-5.

Abstract

OBJECTIVES

This study aimed to evaluate the efficacy, adverse events, patient compliance, and cost of dual therapy with Ilaprazole-amoxicillin (IA) at high dose versus Ilaprazole-amoxicillin-furazolidone-bismuth (IAFB) quadruple therapy for the Helicobacter pylori (H.pylori) infection among Chinese patients.

METHODS

200 patients who had tested positive for H. pylori and undergoing upper gastrointestinal endoscopy after being diagnosed with chronic gastritis participated in this open-label randomized controlled clinical trial. Patients were randomized to Group A and Group B: the 14-day IA dual treatment group (101) and IAFB quadruple treatment group (99). The  C urea breath test was conducted to determine whether H. pylori had been eliminated 4-6 weeks after the treatment. Eradication rates, drug-related adverse events, patient compliance, and drug costs were compared between the two treatment groups.

RESULTS

Eradication rates in group A were 92.1% and 94.9%, depending on the intention-to-treat (ITT), per-protocol (PP), respectively, which was similar to group B (91.9% and 93.6%). There was no significant difference observed in adverse events between the two groups (P = 0.518). Interestingly, compliance was significantly higher in group A compared to the group B (P = 0.031). In addition, drug costs were significantly lower for group A in comparison to the group B.

CONCLUSIONS

IA dual therapy was found to be equally effective, safer and less costly than IAFB quadruple therapy. Therefore, these therapies can be potentially considered as first-line regimens for empirical treatment.

摘要

目的

本研究旨在评估艾拉匹唑-阿莫西林(IA)高剂量双联疗法与艾拉匹唑-阿莫西林-呋喃唑酮-胶体次枸橼酸铋(IAFB)四联疗法治疗中国患者幽门螺杆菌(H. pylori)感染的疗效、不良事件、患者依从性和成本。

方法

200 例经上消化道内镜检查确诊为慢性胃炎且 H. pylori 检测阳性的患者参加了这项开放性、随机对照临床试验。患者随机分为 A 组和 B 组:14 天 IA 双联治疗组(101 例)和 IAFB 四联治疗组(99 例)。治疗 4-6 周后,采用 13C 尿素呼气试验判断 H. pylori 是否被根除。比较两组的根除率、药物相关不良事件、患者依从性和药物成本。

结果

根据意向治疗(ITT)和符合方案(PP)分析,A 组的根除率分别为 92.1%和 94.9%,与 B 组(91.9%和 93.6%)相似。两组间不良事件发生率无统计学差异(P=0.518)。有趣的是,A 组的依从性明显高于 B 组(P=0.031)。此外,A 组的药物成本明显低于 B 组。

结论

IA 双联疗法与 IAFB 四联疗法疗效相当,安全性更好,成本更低。因此,这些疗法可作为经验性治疗的一线方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f97c/10364389/feb394fcbe09/12876_2023_2890_Fig1_HTML.jpg

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