COMPARING THE EFFICACY OF CONCOMITANT THERAPY WITH THE STANDARD TRIPLE REGIMEN AS FIRST LINE THERAPY OF HELICOBACTOR PYLORI ERADICATION

Authors

  • Attique Abou Bakr
  • Naeem Aslam
  • Tayyab Shahzad
  • Imran Mehfooz

DOI:

https://doi.org/10.59058/jaimc.v20i2.38

Keywords:

: H. Pylori Induced Gastritis, Concomitant therapy, Standard triple regimen

Abstract

Objective: To compare the effectiveness of Concomitant therapy with standard triple regimen in H.pylori Eradication.

Methods: It was a randomised control trial at OPD of Department of Gastroenterology, Jinnah Hospital Lahore and involved 170 patients, who fullfilled the selection criteria of study were enrolled in the study from OPD of Department of Gastroenterology, Jinnah Hospital Lahore. 85 cases were given Concomitant therapy (Group-A) and 85 cases were given Standard triple regimen (Group-B). Informed consent was obtained. Demographic information (name, age, and sex) were taken. The mean age was 40.43 ± 17.01 years in the Concomitant therapy group and 42.99 ± 12.98 years in the Standard triple regimen group. In group A, 62% cases had ages less than 45 years, and 37.6% of cases had age 45 years or above. In group B, 68.2% cases had an age less than 45 years and 31.8% of cases had an age of 45 years and above. In group A, 50.6% cases were male and 49.4% cases were female. In group B, 72.9% cases were male and 27.1% cases were female. In group A, 58.8%, 22.4%, and 18.8% of cases had low, middle, and high socioeconomic status respectively. In group B, 57.6%, 29.4 and 13% of cases had low, middle, and high socioeconomic status respectively.

In the Concomiant therapy group, eradication was achieved in 93.8%. In conventional triple regimen, eradication was achieved in 61.4% cases (p-value<0.001).

Conclusions: Eradication achievement was significantly more common with Concomitant therapy as compared to the conventional triple regimen. Concomitant therapy was much effective than the Standard triple regimen in all age groups, both genders, and all socioeconomic groups.

References

Sugano K, Tack J, Kuipers EJ, Graham DY, El-Omar EM, Miura S, Haruma K, Asaka M, Uemura N, Malfer- theiner P; faculty members of Kyoto Global Consensus Conference. Kyoto global consensus report on Heli- cobacter pylori gastritis. Gut. 2015 Sep;64(9):1353- 67. doi: 10.1136/gutjnl-2015-309252. Epub 2015 Jul 17. PMID: 26187502; PMCID: PMC4552923.

Mladenova I, Durazzo M. Transmission of Helico- bacter pylori. Minerva Gastroenterol Dietol 2018; 64: 251-4. DOI: 10.23736/S1121-421X.18.02480-7

Lion, J.; Fand, Y.-J.; Chen, C.-C.; Bair, M.-J.; Chany, C.-Y.; Lee, Y.; Chen, M.-J.; Chen, C.-C.; Tseng, C.; Hsu, Y.-C.; ct al. Concomitant, bismuth quadruple, and 14-day triple therapy in the first-line treatment of Helicobnctc r pylori: A multicentre, open-label, rando- mised trial. Laiicet 2016, 588, 2355-2365. [C mass Ref] Molina-Infants,

J.; Lucendo, A.J.; Angueira, T.; Rodriguez-Tellez, M.; Perez-A isa, A.; Balboa, A.; Barrier, J.; Martin- Noguerol, E.; G6mez-Rodriguez, B.J.; Botargues- Bote, J.M.; ct al. Optimised empiric triple and conco- mitant therapy for Helicobacter yqlori eradication in clinical practice: The OPTRICON study. Alimeiit. P/inriiiacol. Ther. 2015, 4i, 581—589. [C reuse I4ef] [I’ribMec4]

Molina-Infante, J.; Romano, M.; Fernandez-Bermejo, M.; Federico, A.; Gravina, A.G.; Pozzati, L.; Garcia — Abad ia, E.; Vinagre—Rodriguez, G.; Martinez-A Icala, C.; Hernandez-Alonso, M.; et al. Optimized non- bismuth quadruple therapies cure most patients with Helicnl›acter yiJlori infection in populations with high rates of antibicitic resistance. Gastro‹ iit‹'rology 2013, 145, 121-128. [C rc›ssRe I]

Gisbert, J.P.; Molina-Infante, J.; Amador, J.; Bermejo, F.; Bujanda, L.; Calvet, X.; Castro-Fernandez, M.; Cuad rado-Lavin, A.; Elizalde, J.I.; Gene, E.; ct a1. IV Ccinferencia Española de Consenso sobre cl trata- mientci de la infeccion por Hcl icobactet piJlori. Gastt oeiiterol. H‹•ya tol. 2016, 39, 697—721. [Crossllcf] [PubMccl]

Fallone, C.A.; Chiba, N.; van Zanten, S.V.; Fischbach, L.; Gisbert, J.P.; Hunt, R.H.; Jones, N.L.; Render, C.; Leontiadis, G.I.; Moayyedi, P.; et al. The Toronto Con- sensus for the Treatment of Helicobncter pylori Infec- tion in Adults. Gastrot iitrrnlo,gy 2016, 151, 51-69. IC rossRcl] [Pifi Mec4]

Malfertheiner, P.; Megraud, F.; O’Mora in, C.A.; Gis- bert, J.P.; Kuipers, E.J.; Axon, A.T.; Bazzoli, F.; Gas- barrini, A.;Atherton, J.; Graham, D.Y.; et a1. Manage- ment of Helicobacter pylori infection-the Maastricht V/Florence Consensus Report. Ciif 2017, 66, 6—30. [C reuse Incl] [l’ub Meet J

Chey, W.D.; Leontiadis, G.I.; Howden, C.W.; Moss,

S.F. ACG Clinical Guideline: Treatment of Helico- bacter piflori Infection. Am. |. Gnstroeiiterol. 2017, i 7 2, 212-239. [C rr›ssRef]

Karamanolis GP, Daikos GL, Xouris D, Goukos D, Delladetsima I, Ladas SD. The evolution of Helico- bacter pylori antibiotics resistance over 10 years in Greece. Digestion. 2014;90(4):229-31 doi: 10.1136/ gut. 2007.125658. Epub 2007 Jun 12. PMID: 17566020; PMCID: PMC2000235.

Zhu, Yangchun, Xiaoying Zhou, Junbei Wu, Jing Su, and Guoxin Zhang. "Risk factors and prevalence of Helicobacter pylori infection in persistent high inci- dence area of gastric carcinoma in Yangzhong city." Gastroenterology research and practice 2014 (2014).

Tanih NF, Clarke AM, Mkwetshana N, Green E, Ndip LM, Ndip RN. Helicobacter pylori infection in Africa: Pathology and microbiological diagnosis. African Journal of Biotechnology. 2008;7(25).

Zullo A, De Francesco V, Hassan C, Morini S, Vaira D. The sequential therapy regimen for Helicobacter pylori eradication: a pooled-data analysis. Gut. 2007 Oct; 56(10):1353-7

Paoluzi OA, Del Vecchio Blanco G, Visconti E, Coppola M, Fontana C, Favaro M, Pallone F. Low effi- cacy of levofloxacin-doxycycline-based third-line triple therapy for Helicobacter pylori eradication in Italy. World J Gastroenterol 2015; 21(21): 6698-6705 [PMID: 26074708 doi: 10.3748/wjg.v21.i21.6698.

Kohanteb J, Bazargani A, Saberi-Firoozi M, Mobasser

A. Antimicrobial susceptibility testing of Helicobacter pylori to selected agents by agar dilution method in Shiraz-Iran. Indian journal of medical microbiology. 2007 Oct 1;25(4):374-7.

McNicholl, A.G.; Marin, A.C.; Molina-Infante, J.; Castro, M.; Barrio, J.; Ducons, J.; Calx•et, X.; De La Coba, C.;Montoro, M.; Bory, F.; et al. Randomised clinical trial comparing sequential and concomitant therapies for Helicobacter py/or/ eradication in routine clinical practice. Ciif 2013, 63, 244-249. [Ci c›ssItct

Apostolopoulos, P.; Koumoutsos, I.; Ekmektzoglou, K.; Dogantzis, P.; Vlachou, E.; Kalantzis, C.; Tsibouris, P.; Alex and rakis, G. Concomitant versus sequential therapy for the treatment of Helicobncter pi//nri infec- tion: A Greek randomized prospective study. 5cand.J. Castroeiiterol. 2015, 51, 145—151. [CrossRef]

Zullca, A.; Scacciancice, G.; De Francescci, V.; Vannella, L.; Ruggiero, V.; Dambrc sick, P.; Castcirani, L.; Bon- frate, L.; Hassan, C.; Portincasa, P. Sa1909 Concomitant, Sequential, and Hybrid Therapy for H. yiJlori Eradi- cation: A Pilot Study. Carstrut'ii t‹•rolo$y 2013, 144, 647-650 IC rc›ssRcf]

Noh, H.M., Hong, S.J., Han, J.P., Park, K.W., Lee, Y.N., Lee, T.H., Ko, B.M., Lee, J.S. and Lee, M.S., 2016. Eradication rate by the duration of third-line rescue therapy with levofloxacin after Helicobacter pylori treatment failure in clinical practice. The Korean Jour- nal of Gastroenterology, 68(5), pp.260-264

Paoluzi, O.A., Blanco, G.D.V., Visconti, E., Coppola, M., Fontana, C., Favaro, M. and Pallone, F., 2015. Low efficacy of levofloxacin-doxycycline-based third-line triple therapy for Helicobacter pylori eradication in Italy. World Journal of Gastroenterology: WJG, 21(21), p.6698.

Papastergiou, V., Georgopoulos, S.D. and Karatapanis, S., 2014. Treatment of Helicobacter pylori infection: Past, present, and future. World journal of gastrointes- tinal pathophysiology, 5(4), p.392.

Published

09-01-2023

How to Cite

Attique Abou Bakr, Naeem Aslam, Tayyab Shahzad, & Imran Mehfooz. (2023). COMPARING THE EFFICACY OF CONCOMITANT THERAPY WITH THE STANDARD TRIPLE REGIMEN AS FIRST LINE THERAPY OF HELICOBACTOR PYLORI ERADICATION. JAIMC: Journal of Allama Iqbal Medical College, 20(2). https://doi.org/10.59058/jaimc.v20i2.38