TY - JOUR
T1 - Sequential treatment for Helicobacter pylori does not share the risk factors of triple therapy failure
AU - De Francesco, V.
AU - Zullo, A.
AU - Margiotta, M.
AU - Marangi, S.
AU - Burattini, O.
AU - Berloco, P.
AU - Russo, F.
AU - Barone, M.
AU - Di Leo, A.
AU - Minenna, M. F.
AU - Stoppino, V.
AU - Morini, S.
AU - Panella, C.
AU - Francavilla, A.
AU - Ierardi, E.
PY - 2004/2/15
Y1 - 2004/2/15
N2 - Background: Predicting factors for the outcome of conventional Helicobacter pylori triple therapy have been identified. Of these, the presence of the CagA gene is a strong predictor of successful treatment. Our preliminary data show that this factor becomes irrelevant when sequential therapy is used. Aim: To identify predicting factors for the outcome of H. pylori eradication using two therapeutic schemes (triple and sequential) of equal duration (10 days). Methods: Ninety-six patients with H. pylori infection were randomly assigned to receive one of the following therapeutic schemes: group A: rabeprazole (20 mg b.d.) plus amoxicillin (1 g b.d.) for 5 days, followed by rabeprazole (20 mg b.d.) plus tinidazole (500 mg b.d.) and clarithromycin (500 mg b.d.) for a further 5 days; group B: rabeprazole (20 mg b.d.) plus amoxicillin (1 g b.d.) and clarithromycin (500 mg b.d.) for 10 days. Age, sex, smoking, endoscopic and histological findings, and CagA and VacA status were considered as candidates for a model of multivariate analysis which used therapeutic outcome as the dependent variable. CagA and VacA status were assessed by polymerase chain reaction on DNA isolated from gastric antral specimens. Results: The sequential scheme was significantly more effective than prolonged triple therapy (P <0.05). Smoking (P <0.001) and the absence of the CagA gene (P <0.05) were significantly associated with the failure of triple therapy, but the effectiveness of sequential treatment was not predicted by these factors. Conclusion: Our data suggest that sequential therapy is not affected by bacterial and host factors which have, until now, predicted the outcome of conventional eradication treatments.
AB - Background: Predicting factors for the outcome of conventional Helicobacter pylori triple therapy have been identified. Of these, the presence of the CagA gene is a strong predictor of successful treatment. Our preliminary data show that this factor becomes irrelevant when sequential therapy is used. Aim: To identify predicting factors for the outcome of H. pylori eradication using two therapeutic schemes (triple and sequential) of equal duration (10 days). Methods: Ninety-six patients with H. pylori infection were randomly assigned to receive one of the following therapeutic schemes: group A: rabeprazole (20 mg b.d.) plus amoxicillin (1 g b.d.) for 5 days, followed by rabeprazole (20 mg b.d.) plus tinidazole (500 mg b.d.) and clarithromycin (500 mg b.d.) for a further 5 days; group B: rabeprazole (20 mg b.d.) plus amoxicillin (1 g b.d.) and clarithromycin (500 mg b.d.) for 10 days. Age, sex, smoking, endoscopic and histological findings, and CagA and VacA status were considered as candidates for a model of multivariate analysis which used therapeutic outcome as the dependent variable. CagA and VacA status were assessed by polymerase chain reaction on DNA isolated from gastric antral specimens. Results: The sequential scheme was significantly more effective than prolonged triple therapy (P <0.05). Smoking (P <0.001) and the absence of the CagA gene (P <0.05) were significantly associated with the failure of triple therapy, but the effectiveness of sequential treatment was not predicted by these factors. Conclusion: Our data suggest that sequential therapy is not affected by bacterial and host factors which have, until now, predicted the outcome of conventional eradication treatments.
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U2 - 10.1046/j.1365-2036.2004.01818.x
DO - 10.1046/j.1365-2036.2004.01818.x
M3 - Article
C2 - 14871280
AN - SCOPUS:10744231134
VL - 19
SP - 407
EP - 414
JO - Alimentary Pharmacology and Therapeutics
JF - Alimentary Pharmacology and Therapeutics
SN - 0269-2813
IS - 4
ER -