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  • 1
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    14‐day reverse hybrid therapy vs 7‐day concomitant therapy in the first‐line treatment of Helicobacter pylori infection
    Wiley ; 2022
    In:  Advances in Digestive Medicine Vol. 9, No. 1 ( 2022-03), p. 38-43
    Details
    In: Advances in Digestive Medicine, Wiley, Vol. 9, No. 1 ( 2022-03), p. 38-43
    Abstract: Increasing antibiotics resistance poses a great challenge for the treatment of Helicobacter pylori ( H. pylori ) infection. The reported eradication rates of 7‐day standard triple therapy have fallen below 80% in most countries due to increasing clarithromycin resistance. Both 14‐day reverse hybrid therapy and 7‐day concomitant therapy have been reported to yield high eradication rates for the treatment of H. pylori infection. However, whether 14‐day reverse hybrid therapy can achieve a higher eradication rate than 7‐day concomitant therapy remains unanswered. The aim of this study is to compare the efficacies of 14‐day reverse hybrid and 7‐day concomitant therapies for the first‐line treatment of H. pylori infection in a primary care setting. From May 2016 to December 2019, 322 H. pylori ‐infected patients receiving either 14‐day reverse hybrid therapy (a proton pump inhibitor [PPI] plus amoxicillin 1 g b.d. for 14 days, and clarithromycin 500 mg plus metronidazole 500 mg b.d. for the initial 7 days, n = 142) or 7‐day concomitant therapy (PPI plus amoxicillin 1 g, clarithromycin 500 mg, and metronidazole 500 mg b.d. for 7 days, n = 180) in our clinic were included in the retrospective study. All the patients underwent a follow‐up endoscopy with a rapid urease test or a urea breath test at least 4 weeks after completion of anti‐ H. pylori therapy and at least 2 weeks after discontinuation of PPI. Intention‐to‐treat analysis demonstrated a significantly higher eradication rate for the 14‐day reverse hybrid group than for the 7‐day concomitant group (95.8% vs 88.9%, P  = .024). Per‐protocol analysis also yielded similar results (97.8% vs 90.3%, P  = .009). Both groups had similar frequencies of adverse events (14.1% vs 13.9%, P  = .990) and drug compliance (95.8% vs 97.2%, P  = .478). Conclusions Fourteen‐day reverse hybrid therapy achieves a higher eradication rate than 7‐day concomitant therapy in the first‐line treatment of H. pylori infection.
    Type of Medium: Online Resource
    ISSN: 2351-9797 , 2351-9800
    URL: Issue
    URL: Article
    DOI: 10.1002/aid2.v9.1
    DOI: 10.1002/aid2.13243
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2830898-0
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  • 2
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    Hybrid, High-Dose Dual and Bismuth Quadruple Therapies for First-Line Treatment of Helicobacter pylori Infection in Taiwan: A Multicenter, Open-Label, Randomized Trial
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  American Journal of Gastroenterology Vol. 118, No. 7 ( 2023-07), p. 1184-1195
    Details
    In: American Journal of Gastroenterology, Ovid Technologies (Wolters Kluwer Health), Vol. 118, No. 7 ( 2023-07), p. 1184-1195
    Abstract: The study aimed to compare the efficacies and safety of 14-day hybrid therapy, 14-day high-dose dual therapy, and 10-day bismuth quadruple therapy in the first-line treatment of Helicobacter pylori infections. METHODS: In this multicenter, open-label, randomized trial, we recruited adult H. pylori -infected patients from 9 centers in Taiwan. Subjects were randomly assigned (1:1:1) to 14-day hybrid therapy, 14-day high-dose dual therapy, or 10-day bismuth quadruple therapy. Eradication status was determined by the 13 C-urea breath test. The primary outcome was the eradication rate of H. pylori assessed in the intention-to-treat population. RESULTS: Between August 1, 2018, and December 2021, 918 patients were randomly assigned in this study. The intention-to-treat eradication rates were 91.5% (280/306; 95% confidence interval [CI] 88.4%–94.6%) for 14-day hybrid therapy, 83.3% (255/306; 95% CI 87.8%–95.0%) for 14-day high-dose dual therapy, and 90.2% (276/306; 95% CI 87.8%–95.0%) for 10-day bismuth quadruple therapy. Both hybrid therapy (difference 8.2%; 95% CI 4.5%–11.9%; P = 0.002) and bismuth quadruple therapy (difference 6.9%; 95% CI 1.6%–12.2%; P = 0.012) were superior to high-dose dual therapy and were similar to one another. The frequency of adverse events was 27% (81/303) with 14-day hybrid therapy, 13% (40/305) with 14-day high-dose dual therapy, and 32% (96/303) with 10-day bismuth quadruple therapy. Patients receiving high-dose dual therapy had the fewest adverse events (both P 〈 0.001). DISCUSSION: Fourteen-day hybrid therapy and 10-day bismuth quadruple therapy are more effective than 14-day high-dose dual therapy in the first-line treatment of H. pylori infection in Taiwan. However, high-dose dual therapy has fewer adverse effects than hybrid bismuth quadruple therapies.
    Type of Medium: Online Resource
    ISSN: 0002-9270 , 1572-0241
    URL: Article
    DOI: 10.14309/ajg.0000000000002255
    RVK:
    XA 18920
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
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  • 3
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    Update on the second-line treatment of Helicobacter pylori infection: a narrative review
    SAGE Publications ; 2023
    In:  Therapeutic Advances in Gastroenterology Vol. 16 ( 2023-01)
    Details
    In: Therapeutic Advances in Gastroenterology, SAGE Publications, Vol. 16 ( 2023-01)
    Abstract: A standard bismuth quadruple therapy, a fluoroquinolone-containing triple (or quadruple) therapy or a proton pump inhibitor (PPI)-amoxicillin high-dose dual therapy has been recommended as a second-line treatment for Helicobacter pylori infection by the Maastricht VI/Florence Consensus Report. The major shortcoming of levofloxacin-amoxicillin triple therapy is low cure rate for eradicating levofloxacin-resistant strains. With the rising prevalence of levofloxacin-resistant strains, levofloxacin-amoxicillin triple therapy cannot reliably achieve a high eradication rate for second-line treatment of H. pylori infection in most countries now. The present article aims to review current second-line eradication regimens with a per-protocol eradication rate exceeding 85% in most geographic areas. Recently, a novel tetracycline-levofloxacin quadruple therapy consisting of a PPI, bismuth, tetracycline, and levofloxacin for rescue treatment of H. pylori infection has been developed. The new therapy achieved a higher per-protocol eradication rate than levofloxacin-amoxicillin triple treatment in a randomized controlled trial (98% versus 69%). Additionally, the tetracycline-levofloxacin quadruple therapy also exhibits a higher eradication rate than amoxicillin-levofloxacin quadruple therapy. High-dose dual PPI-amoxicillin therapy is another novel second-line treatment for H. pylori infection. The new therapy can achieve an eradication rate of 89% by per-protocol analysis for the second-line treatment in Taiwan. Recently, levofloxacin-based sequential quadruple therapy and potassium-competitive acid blocker have also been applied in the second-line treatment of H. pylori infection. A meta-analysis revealed that a vonoprazan-based regimen has significant superiority over a PPI-based regimen for second-line H. pylori eradication therapy. In conclusion, the eradication rate of levofloxacin-amoxicillin triple therapy is suboptimal in the second-line treatment of H. pylori infection now. Currently, a standard bismuth quadruple therapy (tetracycline-metronidazole quadruple therapy), a tetracycline-levofloxacin quadruple therapy, an amoxicillin-levofloxacin quadruple therapy, a levofloxacin-based sequential quadruple therapy or a high-dose PPI-amoxicillin dual therapy is recommended for the second-line treatment of H. pylori infection.
    Type of Medium: Online Resource
    ISSN: 1756-2848 , 1756-2848
    URL: Article
    DOI: 10.1177/17562848231192750
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2440710-0
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  • 4
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    The efficacy of culture‐guided versus empirical therapy with high‐dose proton pump inhibitor as third‐line treatment of Helicobacter pylori infection: A real‐world clinical experience
    Wiley ; 2022
    In:  Journal of Gastroenterology and Hepatology Vol. 37, No. 10 ( 2022-10), p. 1928-1934
    Details
    In: Journal of Gastroenterology and Hepatology, Wiley, Vol. 37, No. 10 ( 2022-10), p. 1928-1934
    Abstract: Most consensuses recommend culture‐guided therapy as third‐line Helicobacter pylori treatment. This study aimed to investigate the efficacies of culture‐guided therapy and empirical therapy with high‐dose proton pump inhibitor (PPI) in the H. pylori third‐line treatment. Methods Between August 2012 and October 2021, H. pylori ‐infected patients with at least two failed eradication attempts received anti‐ H. pylori therapy according to the results of antimicrobial sensitivity tests plus high‐dose rabeprazole and/or bismuth. They were categorized into three groups: patients who had positive results of culture with equal to or more than three susceptible antibiotics were treated by culture‐guided non‐bismuth quadruple therapy, patients who had positive results of culture with one or two susceptible antibiotics were treated by culture‐guided bismuth‐containing therapy, and patients who had a negative result of culture were treated by an empirical therapy with high‐dose rabeprazole plus amoxicillin, tetracycline and levofloxacin. A post‐treatment assessment was conducted at week 8. Results We recruited 126 patients. The eradication rates of culture‐guided non‐bismuth quadruple therapy ( n  = 50), culture‐guided bismuth‐containing therapy ( n  = 46) and empirical therapy ( n  = 30) were 84.0%, 87.0%, and 66.7% (95% confidence interval: 73.8–94.2%, 77.3–96.7%, and 49.8–83.6%), respectively. Overall, culture‐guided therapy achieved a higher eradication rate than empirical therapy (85.4% vs 66.7%; 95% confidence interval, 0.4% to 37.0%, P  = 0.022). Conclusions Culture‐guided therapy with high‐dose PPI achieves a higher eradication rate than empirical therapy with high‐dose PPI in the third‐line treatment of H. pylori infection. The eradication rate of rescue therapy with bismuth plus two susceptible antibiotics is not inferior to that with three susceptible antibiotics.
    Type of Medium: Online Resource
    ISSN: 0815-9319 , 1440-1746
    URL: Issue
    URL: Article
    DOI: 10.1111/jgh.v37.10
    DOI: 10.1111/jgh.15942
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2006782-3
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  • 5
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    Application of artificial intelligence in endoscopic image analysis for the diagnosis of a gastric cancer pathogen-Helicobacter pylori infection
    Springer Science and Business Media LLC ; 2023
    In:  Scientific Reports Vol. 13, No. 1 ( 2023-08-17)
    Details
    In: Scientific Reports, Springer Science and Business Media LLC, Vol. 13, No. 1 ( 2023-08-17)
    Abstract: Helicobacter pylori ( H. pylori ) infection is the principal cause of chronic gastritis, gastric ulcers, duodenal ulcers, and gastric cancer. In clinical practice, diagnosis of H. pylori infection by a gastroenterologists’ impression of endoscopic images is inaccurate and cannot be used for the management of gastrointestinal diseases. The aim of this study was to develop an artificial intelligence classification system for the diagnosis of H. pylori infection by pre-processing endoscopic images and machine learning methods. Endoscopic images of the gastric body and antrum from 302 patients receiving endoscopy with confirmation of H. pylori status by a rapid urease test at An Nan Hospital were obtained for the derivation and validation of an artificial intelligence classification system. The H. pylori status was interpreted as positive or negative by Convolutional Neural Network (CNN) and Concurrent Spatial and Channel Squeeze and Excitation (scSE) network, combined with different classification models for deep learning of gastric images. The comprehensive assessment for H. pylori status by scSE-CatBoost classification models for both body and antrum images from same patients achieved an accuracy of 0.90, sensitivity of 1.00, specificity of 0.81, positive predictive value of 0.82, negative predicted value of 1.00, and area under the curve of 0.88. The data suggest that an artificial intelligence classification model using scSE-CatBoost deep learning for gastric endoscopic images can distinguish H. pylori status with good performance and is useful for the survey or diagnosis of H. pylori infection in clinical practice.
    Type of Medium: Online Resource
    ISSN: 2045-2322
    URL: Article
    DOI: 10.1038/s41598-023-40179-5
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2615211-3
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  • 6
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    Relief pain of symptomatic annular pancreas in adults: A report of two cases
    Wiley ; 2021
    In:  Advances in Digestive Medicine Vol. 8, No. 3 ( 2021-09), p. 183-186
    Details
    In: Advances in Digestive Medicine, Wiley, Vol. 8, No. 3 ( 2021-09), p. 183-186
    Abstract: Annular pancreas is a rare disease and was first described by Tiedman in 1818. The anomaly is often discovered in neonates or during the first year of life. The clinical presentation can be less severe in the case of young children, and the anomaly can remain asymptomatic and may be discovered fortuitously in adult patients. In adult patients with annular pancreas, the common symptoms include cramping epigastric pain and postprandial abdominal fullness. Associated conditions include duodenal ulcers, acute pancreatitis, carcinoma of the pancreatic head, biliary colic in association with biliary obstruction and jaundice, and obstruction of the gastric outlet. Here, we successfully treated the cases of two adult patients with symptomatic annular pancreas, and we discuss the available diagnostic and therapeutic modalities for the same.
    Type of Medium: Online Resource
    ISSN: 2351-9797 , 2351-9800
    URL: Issue
    URL: Article
    DOI: 10.1002/aid2.v8.3
    DOI: 10.1002/aid2.13215
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2830898-0
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  • 7
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    A prospective, randomized trial of endoscopic hemoclip placement and distilled water injection for treatment of high-risk bleeding ulcers
    Elsevier BV ; 2003
    In:  Gastrointestinal Endoscopy Vol. 57, No. 3 ( 2003-03), p. 324-328
    Details
    In: Gastrointestinal Endoscopy, Elsevier BV, Vol. 57, No. 3 ( 2003-03), p. 324-328
    Type of Medium: Online Resource
    ISSN: 0016-5107
    URL: Article
    DOI: 10.1067/mge.2003.103
    RVK:
    XA 44545
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2003
    detail.hit.zdb_id: 2006253-9
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  • 8
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    Comparison of the Efficacies of Direct-Acting Antiviral Treatment for HCV Infection in People Who Inject Drugs and Non-Drug Users
    MDPI AG ; 2022
    In:  Medicina Vol. 58, No. 3 ( 2022-03-17), p. 436-
    Details
    In: Medicina, MDPI AG, Vol. 58, No. 3 ( 2022-03-17), p. 436-
    Abstract: Background and Objectives: Hepatitis C virus (HCV) is a major cause of liver disease worldwide. People who inject drugs (PWIDs) constitute the majority of patients with HCV infection in the United States and Central Asia. There are several obstacles to treating HCV infection in PWIDs because PWIDs are often accompanied by concurrent infection, low compliance, substance abuse, and risky behavior. The aim of the study is to compare the efficacies of direct-acting antiviral (DAA) therapy for HCV infection in PWIDs and those without opioid injection. Materials and Methods: In this retrospective cohort study, we included 53 PWIDs with HCV infections treated on site in a methadone program and 106 age- and sex-matched patients with HCV infections who had no history of opioid injection (ratio of 1:2). All eligible subjects received anti-HCV treatment by DAA agents in our hospital from March 2018 to December 2020. The charts of these patients were carefully reviewed for demographic data, types of DAA agents, and treatment outcomes. The primary outcome measure was sustained virological response (SVR). Results: PWIDs and non-drug users had different HCV genotype profiles (p = 0.013). The former had higher proportions of genotype 3 (18.9% vs. 7.5%) and genotype 6 (24.5% vs. 14.2%) than the latter. The two patient groups had comparable rates of complete drug refilling (100.0% vs. 91.1%) and frequency of loss to follow-up (3.8% vs. 0.9%). However, PWIDs had a lower SVR rate of DAA treatment than non-drug users (92.2% vs. 99.0%; p = 0.04). Further analysis showed that both human immunodeficiency virus (HIV) coinfection and history of PWID were risk factors associated with treatment failure. The subjects with coinfection with HIV had lower SVR rates than those without HIV infection (50.0% vs. 96.5%; p = 0.021). Conclusions: PWIDs with HCV infections have higher proportions of HCV genotype 3 and genotype 6 than non-drug users with infections. DAA therapy can achieve a high cure rate ( 〉 90%) for HCV infection in PWID, but its efficacy in PWID is lower than that in non-drug users.
    Type of Medium: Online Resource
    ISSN: 1648-9144
    URL: Article
    DOI: 10.3390/medicina58030436
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2088820-X
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  • 9
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    Tetracycline‐levofloxacin versus amoxicillin‐levofloxacin quadruple therapies in the second‐line treatment of Helicobacter pylori infection
    Wiley ; 2021
    In:  Helicobacter Vol. 26, No. 5 ( 2021-10)
    Details
    In: Helicobacter, Wiley, Vol. 26, No. 5 ( 2021-10)
    Abstract: The Maastricht V/Florence Consensus Report recommends amoxicillin‐fluoroquinolone triple or quadruple therapy as a second‐line treatment for Helicobacter pylori infection. An important caveat of amoxicillin‐fluoroquinolone rescue therapy is poor eradication efficacy in the presence of fluoroquinolone resistance. The study aimed to investigate the efficacies of tetracycline‐levofloxacin (TL) quadruple therapy and amoxicillin‐levofloxacin (AL) quadruple therapy in the second‐line treatment of H .  pylori infection. Methods Consecutive H . pylori ‐infected subjects after the failure of first‐line therapies were randomly allocated to receive either TL quadruple therapy (tetracycline 500 mg QID, levofloxacin 500 mg QD, esomeprazole 40 mg BID, and tripotassium dicitrato bismuthate 300 mg QID) or AL quadruple therapy (amoxicillin 500 mg QID, levofloxacin 500 mg QD, esomeprazole 40 mg BID, and tripotassium dicitrato bismuthate 300 mg QID) for 10 days. Post‐treatment H .  pylori status was assessed 6 weeks after the end of therapy. Results The study was early terminated after an interim analysis. In the TL quadruple group, 50 out of 56 patients (89.3%) had successful eradication of H .  pylori infection. Cure of H .  pylori infection was achieved only in 39 of 52 patients (69.6%) receiving AL quadruple therapy. Intention‐to‐treat analysis showed that TL quadruple therapy achieved a markedly higher eradication rate than AL quadruple therapy (95% confidence interval: 4.8% to 34.6%; p  = 0.010). Further analysis revealed that TL quadruple therapy had a high eradication rate for both levofloxacin‐susceptible and resistant strains (100% and 88.9%). In contrast, AL quadruple therapy yielded a high eradication for levofloxacin‐susceptible strains (90.9%) but a poor eradication efficacy for levofloxacin‐resistant strains (50.0%). The two therapies exhibited comparable frequencies of adverse events (37.5% vs 21.4%) and drug adherence (98.2% vs 94.6%). Conclusions Ten‐day TL quadruple therapy is more effective than AL quadruple therapy in the second‐line treatment of H . pylori infection in a population with high levofloxacin resistance.
    Type of Medium: Online Resource
    ISSN: 1083-4389 , 1523-5378
    URL: Issue
    URL: Article
    DOI: 10.1111/hel.v26.5
    DOI: 10.1111/hel.12840
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2020336-6
    SSG: 12
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  • 10
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    Update on the first-line treatment of Helicobacter pylori infection in areas with high and low clarithromycin resistances
    SAGE Publications ; 2022
    In:  Therapeutic Advances in Gastroenterology Vol. 15 ( 2022-01), p. 175628482211381-
    Details
    In: Therapeutic Advances in Gastroenterology, SAGE Publications, Vol. 15 ( 2022-01), p. 175628482211381-
    Abstract: Current international consensuses on Helicobacter pylori eradication therapy recommend that only regimens that reliably produce eradication rates of ⩾90% should be used for empirical treatment. The Real-world Practice & Expectation of Asia-Pacific Physicians and Patients in Helicobacter Pylori Eradication Survey also showed that the accepted minimal eradication rate in H. pylori-infected patients was 91%. According to efficacy prediction model, the per-protocol eradication rates of 7-day and 14-day standard triple therapies fall below 90% when clarithromycin resistance rate ⩾5%. Several strategies including bismuth-containing, non-bismuth-containing quadruple therapies (including sequential, concomitant, hybrid and reverse hybrid therapies), high-dose dual therapy and vonoprazan-based triple therapy have been proposed to increase the eradication rate of H. pylori infection. According to efficacy prediction model, the eradication rate of 14-day concomitant therapy, 14-day hybrid therapy and 7-day vonoprazan-based triple therapy is less than 90% if the frequency of clarithromycin-resistant strains is higher than 90%, 58% and 23%, respectively. To meet the recommendation of the consensus report and patients’ expectation, local surveillance networks for resistance of H. pylori to clarithromycin are required to select appropriate eradication regimens in each geographic region. In areas with low ( 〈 5%) clarithromycin resistance (e.g. Sweden, Philippine, Myanmar and Bhutan), 7-day and 14-day standard triple therapies can be adopted for the first-line treatment of H. pylori infection with eradication rates of ⩾90%. In areas with high (⩾5%) clarithromycin resistance (most other countries worldwide) or unknown clarithromycin resistance, 14-day hybrid, 14-day reverse hybrid, 14-day concomitant and 10- to 14-day bismuth quadruple therapy can be used to treat H. pylori infection.
    Type of Medium: Online Resource
    ISSN: 1756-2848 , 1756-2848
    URL: Article
    DOI: 10.1177/17562848221138168
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2440710-0
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