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Bismuth-containing Quadruple Therapy for Helicobacter Pylori First-line Treatment of Different Tetracycline Doses

Registration Number
NCT05431075
Lead Sponsor
Shandong University
Brief Summary

The researchers collect treatment-naive H.pylori-positive patients from the outpatient clinic. The subjects were randomized to receive a dose and frequency of tetracycline 500mg tid or qid of bismuth quadruple eradication therapy. 6-8 weeks after treatment, the subjects will re-take the 13C-urea breath test. Calculate the eradication rates, adverse reaction rates, patient compliance and cost-effectiveness index of each group.

Detailed Description

The researchers collect treatment-naive H.pylori-positive patients from the outpatient clinic. If the subject meets the selection criteria but not the exclusion criteria, and signs an informed consent form, the researchers randomized the subjects in groups: subjects received a dose and frequency of tetracycline 500mg tid or qid of bismuth-containing quadruple eradication therapy. The medication of groups are as follows. 6-8 weeks after the eradication treatment, the subjects will review the 13C-urea breath test, and the researcher records the results.

After all subjects were tested, the eradication rates, adverse reaction rates, patient compliance and cost-effectiveness index of each group were calculated.

According to the course of treatment, it is randomized into a tid treatment group and a qid treatment group. The two groups of bismuth quadruple regimens are the same, as follows:

Tid group: Amoxicillin 1000mg bid+ Tetracycline 500mg tid+ Bismuth + Esomeprazole 20mg bid Qid group: Amoxicillin 1000mg bid+ Tetracycline 500mg qid+ Bismuth + Esomeprazole 20mg bid

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
406
Inclusion Criteria
  • Patients aged 18-70.
  • Patients with H.pylori infection (Positive for rapid urease test or 13C/14C-urea breath test).
  • Patients who have never received H. pylori eradication treatment.
Exclusion Criteria
  • Patients with serious underlying diseases, such as liver insufficiency (Aspartate aminotransferase or alanine aminotransferase greater than 1.5 times the normal value), renal insufficiency (Cr≥2.0mg/dL or glomerular filtration rate <50 ml/min), immunosuppression, malignant tumors, Coronary heart disease or coronary artery stenosis ≥75%.
  • Patients who are pregnant or lactating or unwilling to take contraceptive measures during the trial.
  • Patients with active gastrointestinal bleeding.
  • Patients with a history of upper gastrointestinal surgery.
  • Patients allergic to treatment drugs.
  • Patients with medication history of bismuth agents, antibiotics, proton pump inhibitor and other drugs within 4 weeks
  • Patients with other behaviors that may increase the risk of illness, such as alcohol and drug abuse
  • Patients who are unwilling or incapable to provide informed consents.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Tid groupAmoxicillinTid group: Amoxicillin 1000mg bid+ Tetracycline 500mg tid+ Bismuth + Esomeprazole 20mg bid
Tid groupTetracycline tidTid group: Amoxicillin 1000mg bid+ Tetracycline 500mg tid+ Bismuth + Esomeprazole 20mg bid
Tid groupEsomeprazole 20mgTid group: Amoxicillin 1000mg bid+ Tetracycline 500mg tid+ Bismuth + Esomeprazole 20mg bid
Tid groupBismuth Potassium CitrateTid group: Amoxicillin 1000mg bid+ Tetracycline 500mg tid+ Bismuth + Esomeprazole 20mg bid
Qid groupTetracycline qidQid group: Amoxicillin 1000mg bid+ Tetracycline 500mg qid+ Bismuth + Esomeprazole 20mg bid
Tid groupColloidal Bismuth PectinTid group: Amoxicillin 1000mg bid+ Tetracycline 500mg tid+ Bismuth + Esomeprazole 20mg bid
Qid groupAmoxicillinQid group: Amoxicillin 1000mg bid+ Tetracycline 500mg qid+ Bismuth + Esomeprazole 20mg bid
Qid groupBismuth Potassium CitrateQid group: Amoxicillin 1000mg bid+ Tetracycline 500mg qid+ Bismuth + Esomeprazole 20mg bid
Qid groupEsomeprazole 20mgQid group: Amoxicillin 1000mg bid+ Tetracycline 500mg qid+ Bismuth + Esomeprazole 20mg bid
Qid groupColloidal Bismuth PectinQid group: Amoxicillin 1000mg bid+ Tetracycline 500mg qid+ Bismuth + Esomeprazole 20mg bid
Primary Outcome Measures
NameTimeMethod
Eradication rateImmediately after follow-up check.

Both intention to treat (ITT) and per-protocol (PP) analyses will be used for the assessment of the eradication rates of Helicobacter pylori infections in two groups. The ITT analysis includes all randomly assigned patients who take at least one dose of the study medications. The PP analysis is limited to patients who take over 90% of the study medications and complete follow-up.

Secondary Outcome Measures
NameTimeMethod
Cost-effectiveness indexImmediately after follow-up check.

Ratio of costs to effectiveness

Patient complianceImmediately after follow-up check.

Good compliance is defined as the actual dosage is within the range of 80%-100% of the dosage that should be taken.

Rate of adverse reactionsImmediately after follow-up check.

Rate of adverse reactions

Trial Locations

Locations (6)

Zhengzhou Central Hospital

🇨🇳

Zhengzhou, Henan, China

Qilu hosipital

🇨🇳

Jinan, Shandong, China

Taierzhuang District People's Hospital

🇨🇳

Taierzhuang, Shandong, China

Yuncheng Hospital of Traditional Chinese Medicine

🇨🇳

Yuncheng, Shandong, China

Zibo Central Hospital

🇨🇳

Zibo, Shandong, China

PKUCare Luzhong Hospital

🇨🇳

Zibo, Shandong, China

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