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Rescue Therapy for Helicobacter Pylori Infection

Registration Number
NCT05874544
Lead Sponsor
Shanghai Jiao Tong University School of Medicine
Brief Summary

Dual therapy containing vonoprazan and amoxicillin had showed excellent eradication results with Helicobacter pylori first-line treatment. However, no study has examined its efficacy for H. pylori rescue treatment. Rifabutin has low antibiotic resistance, superior antibacterial activity in vitro, and stability in the gastric acid environment. Several studies have confirmed the efficacy of rifabutin-containing triple therapy as a first-line or rescue treatment for H. pylori. The purpose of this study was to evaluate the efficacy and safety of dual therapy vesus rifabutin-containing triple therapy versus classical bismuth-containing quadruple therapy as rescue therapy for the eradication of refractory Helicobacter pylori.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
360
Inclusion Criteria
  • Ability and willingness to participate in the study and to sign and give informed consent
  • Confirmed H. pylori infection and with previous treatment experience
Exclusion Criteria
  • subjects naive to H. pylori treatment,
  • under 18 or over 80 years old
  • history of gastrectomy
  • pregnant or lactating women
  • Previous history of tuberculosis
  • Allergy to any of the study drugs
  • severe systemic diseases or malignancy
  • administration of antibiotics, bismuth, antisecretory drugs, or Chinese herb medicine in the preceding 8 weeks

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Tetracycline Bismuth Quadruple TherapyBismuth Potassium CitrateVonoprazan 20mg bid, Bismuth Potassium Citrate 110mg qid, Tetracycline 500mg qid, Metronidazole 400mg qid
Dual TherapyAmoxicillinVonoprazan 20mg bid, amoxicillin 1000mg tid
Tetracycline Bismuth Quadruple TherapyTetracyclineVonoprazan 20mg bid, Bismuth Potassium Citrate 110mg qid, Tetracycline 500mg qid, Metronidazole 400mg qid
Tetracycline Bismuth Quadruple TherapyVonoprazanVonoprazan 20mg bid, Bismuth Potassium Citrate 110mg qid, Tetracycline 500mg qid, Metronidazole 400mg qid
Rifabutin Triple TherapyRifabutinVonoprazan 20mg bid, amoxicillin 1000mg tid, rifabutin 150mg bid
Rifabutin Triple TherapyAmoxicillinVonoprazan 20mg bid, amoxicillin 1000mg tid, rifabutin 150mg bid
Tetracycline Bismuth Quadruple TherapyMetronidazoleVonoprazan 20mg bid, Bismuth Potassium Citrate 110mg qid, Tetracycline 500mg qid, Metronidazole 400mg qid
Rifabutin Triple TherapyVonoprazanVonoprazan 20mg bid, amoxicillin 1000mg tid, rifabutin 150mg bid
Dual TherapyVonoprazanVonoprazan 20mg bid, amoxicillin 1000mg tid
Primary Outcome Measures
NameTimeMethod
Helicobacter pylori eradication rateSix weeks after completion of therapy

Six weeks after completion of therapy, H. pylori eradication was assessed by ¹³C-urea breath test. Eradication was defined as negative result from urea breath test (\<4‰) (4‰ as the cutoff value).

Secondary Outcome Measures
NameTimeMethod
Compliance rateWithin 7 days after completion of therapy

Compliance was defined as poor when they had taken less than 80% of the total medication

Rate of adverse effectsWithin 7 days after completion of therapy

The subjects were asked to grade the severity of adverse events according to their influence on daily activities, experienced as "mild" (transient and well tolerated), "moderate" (causing discomfort and partially interfering with daily activities), or severe" (causing considerable interference with daily activities). In addition, blood test were messured to access function of liver and kidney.

Trial Locations

Locations (3)

Renji Hospital, School of Medicine, Shanghai Jiao Tong University

🇨🇳

Shanghai, Shanghai, China

Shanghai Songjiang District Central Hospital

🇨🇳

Shanghai, Shanghai, China

The Second Affiliated Hospital of Zhejiang University school of Medicine

🇨🇳

Hangzhou, Zhejiang, China

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