Kim Yuri, Ahn Ji Yong, Jung Hwoon-Yong, Noh Jin Hee, Na Hee Kyong, Jung Kee Wook, Lee Jeong Hoon, Kim Do Hoon, Choi Kee Don, Song Ho June, Lee Gin Hyug
Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Asan Digestive Disease Research Institute, Seoul, Korea.
Korean J Helicobacter Up Gastrointest Res. 2023 Dec;23(4):277-282. doi: 10.7704/kjhugr.2023.0042. Epub 2023 Dec 8.
The incidence of treatment failures following standard triple therapy (STT) for eradication (HPE) has reached an unacceptable level. Sequential therapy (SQ) has emerged as a promising approach to counteract the escalation of antibiotic resistance. In this study, we used a chronological cohort dataset to conduct a comparative analysis of the eradication rates, compliance, and adverse events associated with the 7-day STT and SQ.
A total of 789 patients underwent HPE treatment at Asan Medical Center between July 2013 and August 2017. Among them, 378 received a 7-day STT and 411 received a 10-day SQ. Baseline clinical data and treatment parameters were compared between the two treatment groups.
SQ demonstrated an eradication rate of 84.7% (348/411), which was superior to that of the 7-day STT (74.1%; <0.001). The incidence of adverse events was also higher in the SQ group than in the STT group (17.5% vs. 11.1%; =0.01). Nonetheless, treatment compliance was not significantly different between the groups (98.1% [SQ] vs. 96.8% [STT]; =0.38). Among the patients undergoing second-line eradication, the SQ group displayed a lower eradication rate than the STT group (77.8% vs. 92.4%; =0.028). Notably, the overall eradication rate did not differ significantly between the two groups (98.3% [STT] vs. 97.4% [SQ]; =0.56).
SQ exhibited superior efficacy compared with the 7-day STT as a first-line H. pylori treatment. Thus, SQ holds potential to serve as the replacement for the 7-day STT in treatment-naïve patients.
标准三联疗法（STT）根除幽门螺杆菌（HPE）后的治疗失败发生率已达到不可接受的水平。序贯疗法（SQ）已成为应对抗生素耐药性上升的一种有前景的方法。在本研究中，我们使用按时间顺序排列的队列数据集，对7天STT和SQ的根除率、依从性及不良事件进行比较分析。
2013年7月至2017年8月期间，共有789例患者在峨山医学中心接受HPE治疗。其中，378例接受7天STT，411例接受10天SQ。比较两个治疗组的基线临床数据和治疗参数。
SQ的根除率为84.7%（348/411），优于7天STT（74.1%；P<0.001）。SQ组不良事件的发生率也高于STT组（17.5%对11.1%；P=0.01）。尽管如此，两组之间的治疗依从性无显著差异（98.1%[SQ]对96.8%[STT]；P=0.38）。在接受二线根除治疗的患者中，SQ组的根除率低于STT组（77.8%对92.4%；P=0.028）。值得注意的是，两组之间的总体根除率无显著差异（98.3%[STT]对97.4%[SQ]；P=0.56）。
作为一线幽门螺杆菌治疗方法，SQ与7天STT相比疗效更佳。因此，SQ有潜力替代初治患者的7天STT。
