Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Republic of Korea.
Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Clin Transl Gastroenterol. 2023 Nov 1;14(11):e00632. doi: 10.14309/ctg.0000000000000632.
Potassium-competitive acid blockers and proton pump inhibitors/sodium bicarbonate can rapidly increase intragastric pH. In this study, we aimed to compare the clinical outcomes of tegoprazan-based and esomeprazole/sodium bicarbonate-based triple therapies in the treatment of Helicobacter pylori infection.
We retrospectively reviewed the data of patients with H. pylori infection treated with a 14-day tegoprazan-based triple therapy or 14-day esomeprazole/sodium bicarbonate-based triple therapy. The primary end point was the H. pylori eradication rate with first-line treatment in an intention-to-treat analysis. Secondary end points included the eradication rate with first-line therapy in the per-protocol analysis and adverse events associated with eradication therapy.
Of the 854 included patients, 435 were treated with tegoprazan-based therapy, and 419 received esomeprazole/sodium bicarbonate-based therapy. In the intention-to-treat population, no significant difference in eradication rate was detected between the tegoprazan-treated and esomeprazole/sodium bicarbonate-treated groups (78.6% [95% confidence interval (CI), 74.6-82.3%] vs 81.4% [95% CI, 77.4-84.9%], P = 0.313). The per-protocol analysis also revealed a similar eradication rate between groups (tegoprazan vs esomeprazole/sodium bicarbonate: 85.5% [95% CI, 81.8-87.5%] vs 87.8% [95% CI, 84.1-90.7%], P = 0.339). However, abdominal discomfort and diarrhea were more common in the esomeprazole/sodium bicarbonate-treated group than in the tegoprazan-treated group (abdominal discomfort: 1.1% vs 3.8%, P = 0.012; diarrhea: 9.9% vs 21.2%, P < 0.001).
The efficacy of the esomeprazole/sodium bicarbonate-based triple therapy for H. pylori eradication was comparable with that of the tegoprazan-based triple therapy. However, esomeprazole/sodium bicarbonate-based therapy exhibited a higher risk of abdominal discomfort and diarrhea than tegoprazan-based therapy.
钾竞争性酸阻滞剂和质子泵抑制剂/碳酸氢钠可迅速提高胃内 pH 值。本研究旨在比较基于替波拉唑和埃索美拉唑/碳酸氢钠的三联疗法治疗幽门螺杆菌感染的临床疗效。
我们回顾性分析了接受 14 天替波拉唑三联疗法或 14 天埃索美拉唑/碳酸氢钠三联疗法治疗的幽门螺杆菌感染患者的数据。主要终点是意向治疗分析中一线治疗的幽门螺杆菌根除率。次要终点包括方案治疗中一线治疗的根除率和与根除治疗相关的不良事件。
在 854 例纳入的患者中，435 例接受替波拉唑治疗，419 例接受埃索美拉唑/碳酸氢钠治疗。在意向治疗人群中，替波拉唑组和埃索美拉唑/碳酸氢钠组的根除率无显著差异（78.6%[95%可信区间（CI），74.6-82.3%] vs 81.4%[95% CI，77.4-84.9%]，P=0.313）。方案治疗分析也显示两组的根除率相似（替波拉唑与埃索美拉唑/碳酸氢钠：85.5%[95% CI，81.8-87.5%] vs 87.8%[95% CI，84.1-90.7%]，P=0.339）。然而，埃索美拉唑/碳酸氢钠组比替波拉唑组更常见腹部不适和腹泻（腹部不适：1.1% vs 3.8%，P=0.012；腹泻：9.9% vs 21.2%，P<0.001）。
埃索美拉唑/碳酸氢钠三联疗法根除幽门螺杆菌的疗效与替波拉唑三联疗法相当。然而，埃索美拉唑/碳酸氢钠三联疗法的腹部不适和腹泻风险高于替波拉唑三联疗法。
