The efficacy of hybrid therapy as first-line regimen for Helicobacter pylori infection compared with sequential therapy

摘要

Background and Aim: Recent prospective studies have shown that the sequential therapy has not achieved the target Helicobacter pylori eradication rate of 80% in Korea. The aim of this study was to therefore assess the efficacy of the hybrid therapy as a first-line treatment for H.pylori eradication in a prospective trial. Methods: From December 2012 to August 2013, 184 patients with confirmed H.pylori infections received either the 14-day hybrid therapy or the 14-day sequential therapy. Eradication outcomes were evaluated using a 13C-urea breath test at least 4 weeks after treatment cessation. Results: A total of 184 patients (90 receiving hybrid treatment and 94 receiving sequential treatment) completed the study. The eradication rates of the hybrid and sequential therapy groups were 81.1% (73/90; 95% confidence interval [CI]=73.0-89.2%) and 79.8% (75/94; 95%CI=71.7-87.9%), respectively, by intention-to-treat analysis (P=0.821). By per protocol analysis, eradication rates were 85.9% (73/85; 95%CI=78.5-93.3%) and 82.0% (73/89; 95%CI=74.0-89.9%; P=0.489), respectively. There were no significant intergroup differences in treatment compliance or discontinuation induced by severe side effects. Conclusions: The hybrid therapy achieved acceptable eradication rate (85.9%), but not statistically significantly higher rates than the sequential therapy (82.0%). Further studies are therefore needed to identify first-line treatments with even better eradication rates in the Korean population.