比较反向混合疗法和铋剂四联疗法的疗效
2019年3月11日 更新者:Ping-I (William) Hsu, M.D.、Kaohsiung Veterans General Hospital.
比较反向混合疗法和铋剂四联疗法根除幽门螺杆菌的疗效和对胃肠道微生物组的影响
反向混合疗法比铋剂四联疗法获得更高的根除率仍未得到解答。
研究概览
详细说明
我们的研究小组发明的为期 14 天的混合疗法在根除幽门螺杆菌方面似乎非常有前途,根据符合方案和意向治疗分析,分别实现了 99% 和 97% 的出色根除率。
最近,研究人员证明反向混合疗法的根除率高于标准三联疗法。
然而,反向杂交疗法是否比铋剂四联疗法获得更高的根除率仍未得到解答。
研究类型
介入性
注册 (实际的)
352
阶段
- 不适用
联系人和位置
本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。
学习地点
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Kaohsiung、台湾、813
- Kaohsiung Veterans General Hospital
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参与标准
研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
20年 至 90年 (成人、年长者)
接受健康志愿者
不
有资格学习的性别
全部
描述
纳入标准:
- 连续感染幽门螺杆菌的门诊患者,至少 20 岁,内镜证实有消化性溃疡病或胃炎
排除标准:
- 既往幽门螺杆菌根除治疗
- 前 4 周内摄入抗生素或铋剂
- 对所用药物有过敏史的患者
- 既往胃部手术患者
- 并存严重的伴随疾病(例如失代偿性肝硬化、尿毒症)
- 孕妇
学习计划
本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:单身的
武器和干预
参与者组/臂 |
干预/治疗 |
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实验性的:泮托拉唑+铋+四氢呋喃+麦德龙
泮托拉唑 40 毫克,每天两次,次柠檬酸铋 120 毫克,每天四次,四环素 500 毫克,每天四次,甲硝唑 250 毫克,每天四次,共 14 天
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泮托拉唑 40 毫克,每天两次,次柠檬酸铋 120 毫克,每天四次,四环素 500 毫克,每天四次,甲硝唑 250 毫克,每天四次,共 14 天
其他名称:
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有源比较器:(panto+amox+clar+metr)+(panto+amox)
为期 7 天的四联方案,含泮托拉唑 40 mg 每天两次、阿莫西林 1 g 每天两次、克拉霉素 500 mg 每天两次和甲硝唑 500 mg 每天两次,然后是为期 7 天的双联方案含泮托拉唑 40 mg 每天两次和阿莫西林 1 g每天两次
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为期 7 天的四联方案,含泮托拉唑 40 mg 每天两次、阿莫西林 1 g 每天两次、克拉霉素 500 mg 每天两次和甲硝唑 500 mg 每天两次,然后是为期 7 天的双联方案含泮托拉唑 40 mg 每天两次和阿莫西林 1 g每天两次
其他名称:
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
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根除幽门螺杆菌的参与者人数
大体时间:抗幽门螺杆菌治疗结束后第六周
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通过内窥镜尿素酶试验和组织学或尿素呼气试验评估根除结果(完全根除幽门螺杆菌的参与者人数)
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抗幽门螺杆菌治疗结束后第六周
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合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
出版物和有用的链接
负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。
一般刊物
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- Vakil N, Megraud F. Eradication therapy for Helicobacter pylori. Gastroenterology. 2007 Sep;133(3):985-1001. doi: 10.1053/j.gastro.2007.07.008.
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- Gumurdulu Y, Serin E, Ozer B, Kayaselcuk F, Ozsahin K, Cosar AM, Gursoy M, Gur G, Yilmaz U, Boyacioglu S. Low eradication rate of Helicobacter pylori with triple 7-14 days and quadriple therapy in Turkey. World J Gastroenterol. 2004 Mar 1;10(5):668-71. doi: 10.3748/wjg.v10.i5.668.
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- Graham DY, Shiotani A. New concepts of resistance in the treatment of Helicobacter pylori infections. Nat Clin Pract Gastroenterol Hepatol. 2008 Jun;5(6):321-31. doi: 10.1038/ncpgasthep1138. Epub 2008 Apr 29.
- Chuah SK, Tsay FW, Hsu PI, Wu DC. A new look at anti-Helicobacter pylori therapy. World J Gastroenterol. 2011 Sep 21;17(35):3971-5. doi: 10.3748/wjg.v17.i35.3971.
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- Hsu PI, Wu DC, Wu JY, Graham DY. Modified sequential Helicobacter pylori therapy: proton pump inhibitor and amoxicillin for 14 days with clarithromycin and metronidazole added as a quadruple (hybrid) therapy for the final 7 days. Helicobacter. 2011 Apr;16(2):139-45. doi: 10.1111/j.1523-5378.2011.00828.x.
- Hsu PI, Lai KH, Tseng HH, Liu YC, Yen MY, Lin CK, Lo GH, Huang RL, Huang JS, Cheng JS, Huang WK, Ger LP, Chen W, Hsu PN. Correlation of serum immunoglobulin G Helicobacter pylori antibody titers with histologic and endoscopic findings in patients with dyspepsia. J Clin Gastroenterol. 1997 Dec;25(4):587-91. doi: 10.1097/00004836-199712000-00007.
- Peng NJ, Lai KH, Liu RS, Lee SC, Tsay DG, Lo CC, Tseng HH, Huang WK, Lo GH, Hsu PI. Clinical significance of oral urease in diagnosis of Helicobacter pylori infection by [13C]urea breath test. Dig Dis Sci. 2001 Aug;46(8):1772-8. doi: 10.1023/a:1010626225949.
- Zullo A, De Francesco V, Hassan C, Morini S, Vaira D. The sequential therapy regimen for Helicobacter pylori eradication: a pooled-data analysis. Gut. 2007 Oct;56(10):1353-7. doi: 10.1136/gut.2007.125658. Epub 2007 Jun 12.
- Essa AS, Kramer JR, Graham DY, Treiber G. Meta-analysis: four-drug, three-antibiotic, non-bismuth-containing "concomitant therapy" versus triple therapy for Helicobacter pylori eradication. Helicobacter. 2009 Apr;14(2):109-18. doi: 10.1111/j.1523-5378.2009.00671.x.
- Chey WD, Wong BC; Practice Parameters Committee of the American College of Gastroenterology. American College of Gastroenterology guideline on the management of Helicobacter pylori infection. Am J Gastroenterol. 2007 Aug;102(8):1808-25. doi: 10.1111/j.1572-0241.2007.01393.x. Epub 2007 Jun 29.
- De Francesco V, Margiotta M, Zullo A, Hassan C, Troiani L, Burattini O, Stella F, Di Leo A, Russo F, Marangi S, Monno R, Stoppino V, Morini S, Panella C, Ierardi E. Clarithromycin-resistant genotypes and eradication of Helicobacter pylori. Ann Intern Med. 2006 Jan 17;144(2):94-100. doi: 10.7326/0003-4819-144-2-200601170-00006.
- Megraud F. H pylori antibiotic resistance: prevalence, importance, and advances in testing. Gut. 2004 Sep;53(9):1374-84. doi: 10.1136/gut.2003.022111. No abstract available.
- Malfertheiner P, Bazzoli F, Delchier JC, Celinski K, Giguere M, Riviere M, Megraud F; Pylera Study Group. Helicobacter pylori eradication with a capsule containing bismuth subcitrate potassium, metronidazole, and tetracycline given with omeprazole versus clarithromycin-based triple therapy: a randomised, open-label, non-inferiority, phase 3 trial. Lancet. 2011 Mar 12;377(9769):905-13. doi: 10.1016/S0140-6736(11)60020-2. Epub 2011 Feb 21. Erratum In: Lancet. 2011 Nov 19;378(9805):1778. Dosage error in article text.
- Hsu PI, Wu DC, Chen A, Peng NJ, Tseng HH, Tsay FW, Lo GH, Lu CY, Yu FJ, Lai KH. Quadruple rescue therapy for Helicobacter pylori infection after two treatment failures. Eur J Clin Invest. 2008 Jun;38(6):404-9. doi: 10.1111/j.1365-2362.2008.01951.x. Epub 2008 Apr 22.
- Asaka M, Kato M, Takahashi S, Fukuda Y, Sugiyama T, Ota H, Uemura N, Murakami K, Satoh K, Sugano K; Japanese Society for Helicobacter Research. Guidelines for the management of Helicobacter pylori infection in Japan: 2009 revised edition. Helicobacter. 2010 Feb;15(1):1-20. doi: 10.1111/j.1523-5378.2009.00738.x. Erratum In: Helicobacter. 2012 Jun;17(3):241.
- Luther J, Higgins PD, Schoenfeld PS, Moayyedi P, Vakil N, Chey WD. Empiric quadruple vs. triple therapy for primary treatment of Helicobacter pylori infection: Systematic review and meta-analysis of efficacy and tolerability. Am J Gastroenterol. 2010 Jan;105(1):65-73. doi: 10.1038/ajg.2009.508. Epub 2009 Sep 15.
- De Francesco V, Margiotta M, Zullo A, Hassan C, Giorgio F, Burattini O, Stoppino G, Cea U, Pace A, Zotti M, Morini S, Panella C, Ierardi E. Prevalence of primary clarithromycin resistance in Helicobacter pylori strains over a 15 year period in Italy. J Antimicrob Chemother. 2007 Apr;59(4):783-5. doi: 10.1093/jac/dkm005. Epub 2007 Feb 28.
- Sardarian H, Fakheri H, Hosseini V, Taghvaei T, Maleki I, Mokhtare M. Comparison of hybrid and sequential therapies for Helicobacter pylori eradication in Iran: a prospective randomized trial. Helicobacter. 2013 Apr;18(2):129-34. doi: 10.1111/hel.12017. Epub 2012 Nov 4.
- Zullo A, Scaccianoce G, De Francesco V, Ruggiero V, D'Ambrosio P, Castorani L, Bonfrate L, Vannella L, Hassan C, Portincasa P. Concomitant, sequential, and hybrid therapy for H. pylori eradication: a pilot study. Clin Res Hepatol Gastroenterol. 2013 Dec;37(6):647-50. doi: 10.1016/j.clinre.2013.04.003. Epub 2013 Jun 6.
- De Francesco V, Hassan C, Ridola L, Giorgio F, Ierardi E, Zullo A. Sequential, concomitant and hybrid first-line therapies for Helicobacter pylori eradication: a prospective randomized study. J Med Microbiol. 2014 May;63(Pt 5):748-752. doi: 10.1099/jmm.0.072322-0. Epub 2014 Feb 28.
- Oh DH, Lee DH, Kang KK, Park YS, Shin CM, Kim N, Yoon H, Hwang JH, Jeoung SH, Kim JW, Jang ES, Jung HC. Efficacy of hybrid therapy as first-line regimen for Helicobacter pylori infection compared with sequential therapy. J Gastroenterol Hepatol. 2014 Jun;29(6):1171-6. doi: 10.1111/jgh.12518.
- Wang B, Wang YH, Lv ZF, Xiong HF, Wang H, Yang Y, Xie Y. Review: efficacy and safety of hybrid therapy for Helicobacter pylori infection: a systematic review and meta-analysis. Helicobacter. 2015 Apr;20(2):79-88. doi: 10.1111/hel.12180. Epub 2014 Nov 8.
- Molina-Infante J, Romano M, Fernandez-Bermejo M, Federico A, Gravina AG, Pozzati L, Garcia-Abadia E, Vinagre-Rodriguez G, Martinez-Alcala C, Hernandez-Alonso M, Miranda A, Iovene MR, Pazos-Pacheco C, Gisbert JP. Optimized nonbismuth quadruple therapies cure most patients with Helicobacter pylori infection in populations with high rates of antibiotic resistance. Gastroenterology. 2013 Jul;145(1):121-128.e1. doi: 10.1053/j.gastro.2013.03.050. Epub 2013 Apr 3.
- Georgopoulos SD, Papastergiou V, Karatapanis S. Helicobacter pylori Eradication Therapies in the Era of Increasing Antibiotic Resistance: A Paradigm Shift to Improved Efficacy. Gastroenterol Res Pract. 2012;2012:757926. doi: 10.1155/2012/757926. Epub 2012 Jun 19.
- Rimbara E, Fischbach LA, Graham DY. Optimal therapy for Helicobacter pylori infections. Nat Rev Gastroenterol Hepatol. 2011 Feb;8(2):79-88. doi: 10.1038/nrgastro.2010.210.
- Hsu PI, Wu DC, Chen WC, Tseng HH, Yu HC, Wang HM, Kao SS, Lai KH, Chen A, Tsay FW. Randomized controlled trial comparing 7-day triple, 10-day sequential, and 7-day concomitant therapies for Helicobacter pylori infection. Antimicrob Agents Chemother. 2014 Oct;58(10):5936-42. doi: 10.1128/AAC.02922-14. Epub 2014 Jul 28.
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研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始
2015年2月1日
初级完成 (实际的)
2018年10月1日
研究完成 (实际的)
2018年10月1日
研究注册日期
首次提交
2015年9月6日
首先提交符合 QC 标准的
2015年9月9日
首次发布 (估计)
2015年9月11日
研究记录更新
最后更新发布 (实际的)
2019年6月10日
上次提交的符合 QC 标准的更新
2019年3月11日
最后验证
2019年3月1日
更多信息
此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.
幽门螺杆菌感染的临床试验
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Fundación de Investigación Biomédica - Hospital...完全的
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University of NottinghamUniversity of Oxford; Nottingham University Hospitals NHS Trust; University of Southampton; Queen... 和其他合作者完全的
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Bernhard Nocht Institute for Tropical MedicineUniversitätsklinikum Hamburg-Eppendorf; Kwame Nkrumah University of Science and Technology; Kumasi... 和其他合作者完全的
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Weill Medical College of Cornell University招聘中