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  3. Bismuth quadruple regimen with tetracycline or doxycycline versus three-in-one single capsule as third-line rescue therapy forHelicobacter pyloriinfection: Spanish data of the EuropeanHelicobacter pyloriRegistry (Hp-EuReg)

Bismuth quadruple regimen with tetracycline or doxycycline versus three-in-one single capsule as third-line rescue therapy forHelicobacter pyloriinfection: Spanish data of the EuropeanHelicobacter pyloriRegistry (Hp-EuReg)

Fecha de publicación: Fecha Ahead of Print:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Nyssen, OP
  • Perez-Aisa, A
  • Rodrigo, L
  • Castro, M
  • Romero, PM
  • Barrio, J
  • Huguet, JM
  • Modollel, I
  • Alcaide, N
  • Lucendo, A
  • Calvet, X
  • Perona, M
  • Gomez, B
  • Rodriguez, BJG
  • Varela, P
  • Jimenez-Moreno, M
  • Dominguez-Cajal, M
  • Pozzati, L
  • Burgos, D
  • Bujanda, L
  • Hinojosa, J
  • Molina-Infante, J
  • Ferrer, L
  • Fern?ndez-Salazar, L
  • Figuerola, A
  • Tito, L
  • de la Coba, C
  • Gomez-Camarero, J
  • Fernandez, N
  • Caldas, M
  • Garre, A
  • Resina, E
  • Puig, I
  • O'Morain, C
  • Megraud, F
  • Gisbert, JP

Grupos

Abstract

Background Different bismuth quadruple therapies containing proton-pump inhibitors, bismuth salts, metronidazole, and a tetracycline have been recommended as third-lineHelicobacter pylorieradication treatment after failure with clarithromycin and levofloxacin. Aim To evaluate the efficacy and safety of third-line treatments with bismuth, metronidazole, and either tetracycline or doxycycline. Methods Sub-study with Spanish data of the "European Registry onH pyloriManagement" (Hp-EuReg), international multicenter prospective non-interventional Registry of the routine clinical practice of gastroenterologists. After previous failure with clarithromycin- and levofloxacin-containing therapies, patients receiving a third-line regimen with 10/14-day bismuth salts, metronidazole, and either tetracycline (BQT-Tet) or doxycycline (BQT-Dox), or single capsule (BQT-three-in-one) were included. Data were registered at AEG-REDCap database. Univariate and multivariate analyses were performed. Results Four-hundred and fifty-four patients have been treated so far: 85 with BQT-Tet, 94 with BQT-Dox, and 275 with BQT-three-in-one. Average age was 53 years, 68% were women. Overall modified intention-to-treat and per-protocol eradication rates were 81% (BQT-Dox: 65%, BQT-Tet: 76%, BQT-three-in-one: 88%) and 82% (BQT-Dox: 66%, BQT-Tet: 77%, BQT-three-in-one: 88%), respectively. By logistic regression, higher eradication rates were associated with compliance (OR = 2.96; 95% CI = 1.01-8.84) and no prior metronidazole use (OR = 1.96; 95% CI = 1.15-3.33); BQT-three-in-one was superior to BQT-Dox (OR = 4.46; 95% CI = 2.51-8.27), and BQT-Tet was marginally superior to BQT-Dox (OR = 1.67; 95% CI = 0.85-3.29). Conclusion Third-lineH pylorieradication with bismuth quadruple treatment (after failure with clarithromycin and levofloxacin) offers acceptable efficacy and safety. Highest efficacy was found in compliant patients and those taking 10-day BQT-three-in-one or 14-day BQT-Tet. Doxycycline seems to be less effective and therefore should not be recommended.

Datos de la publicación

ISSN/ISSNe:
1083-4389, 1523-5378

HELICOBACTER  WILEY

Tipo:
Article
Páginas:
-
PubMed:
32656898
Factor de Impacto:
1,206 SCImago ℠
Cuartil:
Q1 SCImago ℠

Citas Recibidas en Web of Science: 21

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Keywords

  • bismuth; doxycycline; Helicobacter pylori; metronidazole; Pylera(R); tetracycline

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