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A Comparison of Four Different Treatment Regimens of Helicobacter Pylori in Chinese Children

Not Applicable
Recruiting
Conditions
Helicobacter Infections
Interventions
Drug: triple therapy
Drug: sequential therapy
Drug: bismuth quadruple therapy
Drug: concomitant therapy
Registration Number
NCT03365609
Lead Sponsor
Ying HUANG
Brief Summary

With the resistance of Helicobacter pylori increasing, low and unsatisfactory eradication rate (64%) have been observed with standard triple therapy in European children. Which regimen is appropriate for Chinese children? There is no large scale, multi center studies in China about treatment, CYP2C19 gene polymorphism, resistance rate and resistance genotype. Investigators want to perform a research to compare four different treatment regimens(triple therapy, sequential therapy, bismuth quadruple therapy and concomitant therapy)as the first-line treatment of Helicobacter pylori in Chinese children and investigation of resistance, impact factors and changes of microbiota after the therapy. The results of the study will provide theoretical basis to make the new guideline of diagnosis and therapy of Helicobacter pylori in Chinese children. It advance instruct and norm the clinical practice for Chinese pediatrician to increase the cure rate of Helicobacter pylori and decrease the resistance.

Detailed Description

Eligible children were randomly divided into four groups: standard triple therapy, sequential therapy, bismuth quadruple therapy and concomitant therapy. The course of treatment is 14 days. The primary outcome measure was the Hp eradication rate at 4-6 weeks after completion of treatment which was confirmed by a negative of 13 UBT. Secondary outcome measures included side effects, impact factor and changes of microbiome after the therapy.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
1440
Inclusion Criteria
  • children 6-18 years of age who were referred for upper endoscopy and confirmed to have Hp infection
Exclusion Criteria
  • patients were excluded if they had taken proton pump inhibitors, H2-receptor antagonists or antibiotics in the 4 weeks prior to the study. Patients with known antibiotic allergy,hepatic impairment or kidney failure were also excluded. Patients who received Hp therapy before were also excluded.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
T-grouptriple therapyT-group(triple therapy)
S-groupsequential therapyS-group( sequential therapy)
B-groupbismuth quadruple therapyB-group( bismuth quadruple therapy )
C-groupconcomitant therapyC-group( concomitant therapy)
Primary Outcome Measures
NameTimeMethod
13C-UBT13C-UBT was assessed at 4-6 weeks after completion of therapy

13C-UBT was used to determine whether Hp treatments was successful

Secondary Outcome Measures
NameTimeMethod
side effectsassess at 2,4-6weeks after completion of the therapy

such as diarrea,rash,dark stool

changes of Shannon diversity indices for gut microbiomeassess at 0,2,4-6weeks after completion of the therapy

changes of the Shannon diversity indices

changes of abundances for gut microbiomeassess at ,2,4-6weeks after completion of the therapy

changes of abundances of the bacteria

CYP2C19 gene that impact the metabolism of PPIdetect the gene before the therapy

CYP2C19 gene polymorphism

virulence gene-cagAdetect the gene before the therapy

cagA

patient complianceassess compliance 2 weeks after the therapy

good compliance is defined as taking more than 80% drugs

changes of OTU for gut microbiomeassess at 0,2,4-6weeks after completion of the therapy

changes of OTU

virulence gene-vacAdetect the gene before the therapy

vacA

Trial Locations

Locations (1)

Children's hospital of Fudan university

🇨🇳

Shanghai, Shanghai, China

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