Comparison of eradication rates of moxifloxacin–rifabutin triple therapy and bismuth quadruple therapy as second‐line regimens in patients with peptic ulcers
Abstract Background Bismuth quadruple (BQ) therapy is known to have poor patient compliance and a complex dosing method, and no appropriate third‐line regimen exists if second‐line BQ therapy fails. In Korea, some alternative regimens have shown unsatisfactory eradication rates. Therefore, we invest...
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| Format: | Article |
| Language: | English |
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Wiley
2022-09-01
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| Series: | Health Science Reports |
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| Online Access: | https://doi.org/10.1002/hsr2.780 |
| _version_ | 1797772365859389440 |
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| author | Chang Min Lee Seong Je Kim Se In Hah Ji Yoon Kwak Jung Woo Choi Hyun Chin Cho Chang Yoon Ha Ok Jae Lee Woon Tae Jung |
| author_facet | Chang Min Lee Seong Je Kim Se In Hah Ji Yoon Kwak Jung Woo Choi Hyun Chin Cho Chang Yoon Ha Ok Jae Lee Woon Tae Jung |
| author_sort | Chang Min Lee |
| collection | DOAJ |
| description | Abstract Background Bismuth quadruple (BQ) therapy is known to have poor patient compliance and a complex dosing method, and no appropriate third‐line regimen exists if second‐line BQ therapy fails. In Korea, some alternative regimens have shown unsatisfactory eradication rates. Therefore, we investigated the success rates of the second‐line moxifloxacin–rifabutin triple (MRT) regimen and compared it with BQ regimen in subgroup analysis of peptic ulcer patients. Materials and Methods This study was a retrospective study of 71 patients who underwent a second‐line MRT for Helicobacter pylori after failing to clarithromycin triple regimen. To compare the eradication rate in gastric ulcer patients, 51 patients in the MRT group and 132 patients in BQ group were included. After age and sex propensity matching, 45 patients were included in each group (the alpha value and power were set at 0.05% and 77%, respectively). Results The eradication rate in the MRT group was 69.0% (49/71) in the intention‐to‐treat (ITT) analysis and 77.8% (49/63) in the per‐protocol (PP) analysis. These were significantly lower than the eradication rate in the BQ group (82.5%, p = 0.019 in the ITT analysis; 89.3%, p = 0.022 in the PP analysis). In subgroup analysis of peptic ulcer patients, the success rate of BQ group was significantly higher than that of MRT group in both ITT and PP populations (81.8% (108/132) vs. 60.8% (31/51) in the ITT populations, p = 0.004; and 90.0% (108/120) vs. 72.1% (31/43) in the PP populations, p = 0.010). Among the 14 patients with MRT therapy failure, 10 were eradicated with BQ as the third‐line regimen. The eradication rate of the third‐line BQ after the second‐line MRT failure was 90.0% (9/10). Conclusion Second‐line MRT therapy was not as effective as BQ therapy, so it should be considered for limited use only when BQ is not available. |
| first_indexed | 2024-03-12T21:49:51Z |
| format | Article |
| id | doaj.art-140ad0d80af5453995b84adf0daf9b60 |
| institution | Directory Open Access Journal |
| issn | 2398-8835 |
| language | English |
| last_indexed | 2024-03-12T21:49:51Z |
| publishDate | 2022-09-01 |
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| series | Health Science Reports |
| spelling | doaj.art-140ad0d80af5453995b84adf0daf9b602023-07-26T04:11:54ZengWileyHealth Science Reports2398-88352022-09-0155n/an/a10.1002/hsr2.780Comparison of eradication rates of moxifloxacin–rifabutin triple therapy and bismuth quadruple therapy as second‐line regimens in patients with peptic ulcersChang Min Lee0Seong Je Kim1Se In Hah2Ji Yoon Kwak3Jung Woo Choi4Hyun Chin Cho5Chang Yoon Ha6Ok Jae Lee7Woon Tae Jung8Department of Internal Medicine Gyeongsang National University College of Medicine and Gyeongsang National University Hospital Jinju Republic of KoreaDepartment of Internal Medicine Gyeongsang National University College of Medicine and Gyeongsang National University Hospital Jinju Republic of KoreaDepartment of Internal Medicine Gyeongsang National University College of Medicine and Gyeongsang National University Hospital Jinju Republic of KoreaDepartment of Internal Medicine Gyeongsang National University College of Medicine and Gyeongsang National University Hospital Jinju Republic of KoreaDepartment of Internal Medicine Gyeongsang National University College of Medicine and Gyeongsang National University Hospital Jinju Republic of KoreaDepartment of Internal Medicine Gyeongsang National University College of Medicine and Gyeongsang National University Hospital Jinju Republic of KoreaDepartment of Internal Medicine Gyeongsang National University College of Medicine and Gyeongsang National University Hospital Jinju Republic of KoreaDepartment of Internal Medicine Gyeongsang National University College of Medicine and Gyeongsang National University Hospital Jinju Republic of KoreaDepartment of Internal Medicine Gyeongsang National University College of Medicine and Gyeongsang National University Hospital Jinju Republic of KoreaAbstract Background Bismuth quadruple (BQ) therapy is known to have poor patient compliance and a complex dosing method, and no appropriate third‐line regimen exists if second‐line BQ therapy fails. In Korea, some alternative regimens have shown unsatisfactory eradication rates. Therefore, we investigated the success rates of the second‐line moxifloxacin–rifabutin triple (MRT) regimen and compared it with BQ regimen in subgroup analysis of peptic ulcer patients. Materials and Methods This study was a retrospective study of 71 patients who underwent a second‐line MRT for Helicobacter pylori after failing to clarithromycin triple regimen. To compare the eradication rate in gastric ulcer patients, 51 patients in the MRT group and 132 patients in BQ group were included. After age and sex propensity matching, 45 patients were included in each group (the alpha value and power were set at 0.05% and 77%, respectively). Results The eradication rate in the MRT group was 69.0% (49/71) in the intention‐to‐treat (ITT) analysis and 77.8% (49/63) in the per‐protocol (PP) analysis. These were significantly lower than the eradication rate in the BQ group (82.5%, p = 0.019 in the ITT analysis; 89.3%, p = 0.022 in the PP analysis). In subgroup analysis of peptic ulcer patients, the success rate of BQ group was significantly higher than that of MRT group in both ITT and PP populations (81.8% (108/132) vs. 60.8% (31/51) in the ITT populations, p = 0.004; and 90.0% (108/120) vs. 72.1% (31/43) in the PP populations, p = 0.010). Among the 14 patients with MRT therapy failure, 10 were eradicated with BQ as the third‐line regimen. The eradication rate of the third‐line BQ after the second‐line MRT failure was 90.0% (9/10). Conclusion Second‐line MRT therapy was not as effective as BQ therapy, so it should be considered for limited use only when BQ is not available.https://doi.org/10.1002/hsr2.780bismuth quadrupleeradicationHelicobacter pylorimoxifloxacinrifabutin |
| spellingShingle | Chang Min Lee Seong Je Kim Se In Hah Ji Yoon Kwak Jung Woo Choi Hyun Chin Cho Chang Yoon Ha Ok Jae Lee Woon Tae Jung Comparison of eradication rates of moxifloxacin–rifabutin triple therapy and bismuth quadruple therapy as second‐line regimens in patients with peptic ulcers Health Science Reports bismuth quadruple eradication Helicobacter pylori moxifloxacin rifabutin |
| title | Comparison of eradication rates of moxifloxacin–rifabutin triple therapy and bismuth quadruple therapy as second‐line regimens in patients with peptic ulcers |
| title_full | Comparison of eradication rates of moxifloxacin–rifabutin triple therapy and bismuth quadruple therapy as second‐line regimens in patients with peptic ulcers |
| title_fullStr | Comparison of eradication rates of moxifloxacin–rifabutin triple therapy and bismuth quadruple therapy as second‐line regimens in patients with peptic ulcers |
| title_full_unstemmed | Comparison of eradication rates of moxifloxacin–rifabutin triple therapy and bismuth quadruple therapy as second‐line regimens in patients with peptic ulcers |
| title_short | Comparison of eradication rates of moxifloxacin–rifabutin triple therapy and bismuth quadruple therapy as second‐line regimens in patients with peptic ulcers |
| title_sort | comparison of eradication rates of moxifloxacin rifabutin triple therapy and bismuth quadruple therapy as second line regimens in patients with peptic ulcers |
| topic | bismuth quadruple eradication Helicobacter pylori moxifloxacin rifabutin |
| url | https://doi.org/10.1002/hsr2.780 |
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