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  3. Bismuth quadruple regimen with tetracycline or doxycycline versus three-in-one single capsule as third-line rescue therapy for Helicobacter pylori infection: Spanish data of the European Helicobacter pylori Registry (Hp-EuReg)

Bismuth quadruple regimen with tetracycline or doxycycline versus three-in-one single capsule as third-line rescue therapy for Helicobacter pylori infection: Spanish data of the European Helicobacter pylori Registry (Hp-EuReg)

Fecha de publicación:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Nyssen O.P.
  • Perez-Aisa A.
  • Rodrigo L.
  • Castro M.
  • Mata Romero P.
  • Barrio J.
  • Huguet J.M.
  • Modollel I.
  • Alcaide N.
  • Lucendo A.
  • Calvet X.
  • Perona M.
  • Gomez B.
  • Gomez Rodriguez B.J.
  • Varela P.
  • Jimenez-Moreno M.
  • Dominguez-Cajal M.
  • Pozzati L.
  • Burgos D.
  • Bujanda L.
  • Hinojosa J.
  • Molina-Infante J.
  • Ferrer L.
  • Fernández-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 J.P.

Grupos

Abstract

Background: Different bismuth quadruple therapies containing proton-pump inhibitors, bismuth salts, metronidazole, and a tetracycline have been recommended as third-line Helicobacter pylori eradication 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 on H pylori Management” (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-line H pylori eradication 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. © 2020 John Wiley & Sons Ltd

Datos de la publicación

ISSN/ISSNe:
1083-4389, 1523-5378

HELICOBACTER  WILEY

Tipo:
Article
Páginas:
-
PubMed:
32656898
Enlace a otro recurso:
www.scopus.com
Factor de Impacto:
1,206 SCImago ℠
Cuartil:
Q1 SCImago ℠

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Keywords

  • Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Bismuth; Doxycycline; Drug Combinations; Drug Therapy, Combination; Female; Helicobacter Infections; Helicobacter pylori; Humans; Male; Metronidazole; Middle Aged; Prospective Studies; Proton Pump Inhibitors; Spain; Tetracycline; Treatment Outcome; Young Adult; bismuth citrate plus metronidazole plus tetracycline; clarithromycin; doxycycline; levofloxacin; antiinfective agent; bismuth; doxycycline; metronidazole; proton pump inhibitor; tetracycline; abdominal pain; adult; anorexia; Article; clinical effectiveness; clinical evaluation; diarrhea; disease association; disease registry; drug efficacy; drug indication; drug safety; eradication therapy; fatigue; female; Helicobacter infection; human; lack of drug effect; major clinical study; male; metallic taste; nausea; priority journal; sex ratio; treatment outcome; treatment planning; vomiting; adolescent; aged; combination drug therapy; drug combination; drug effect; Hel

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