Helicobacter pylori (H. pylory) infection is the main cause of several gastrointestinal diseases, such as dyspepsia, peptic ulcer or gastritis. In fact, more than half of the world’s population is infected with this bacteria, according to the Pan American Health Organization (PAHO), which also highlights that “gastric cancer causes more than one million deaths in the world and 90% “Of these tumors are secondary to infection by H. pylori, a bacteria that in 1994 was declared by the World Health Organization (WHO) as a type I carcinogen.”
Eliminating this pathogen is therefore a real challenge for science. Now a new collaborative study from the European Registry on Helicobacter pylori Management (Hp-EuReg) coordinated by Spanish researchers from the Liver Diseases area of CIBER (CIBEREHD) has found that an alternative regimen of quadruple therapy with bismuth in a single capsule for the eradication treatment of Helicobacter pylori is more effective than the traditional regimen.
According to clinical consensus on H. pylori eradication, a therapy is considered optimal when it achieves a minimum eradication rate of 90%; This is because none of the current therapies is capable of guaranteeing a 100% eradication rate, mainly due to the increase in antibiotic resistance.
Adherence to treatment, key to eradicating H. pylori
One of the key pieces to achieving high H. pylori eradication rates is adherence to treatment. Several previous studies have shown that the number of daily feedings is closely related to adherence. For this reason, scBQT is a treatment whose adherence is greater than that of other classic quadruple therapies. Furthermore, using the new regimen suggested in this study, changing scBQT intakes from four a day to three, adherence to treatment could be increased.
3,712 patients from Spain treated with scBQT participated in the new study. Of these patients, 2,516 (68%) received the traditional regimen, 3 capsules every six hours, and 1,196 (32%) received the alternative regimen, 4 capsules 3 times a day.
Regarding effectiveness, the overall eradication rate was higher with the regimen of 4 capsules 3 times a day than with the regimen of 3 capsules 4 times a day, 94% versus 91%, respectively. Overall, the highest eradication rate was obtained in the first line of treatment (94%), and this was precisely higher with the alternative regimen of 4 capsules 3 times a day (96% versus 93%).
None of the current therapies is capable of guaranteeing a 100% eradication rate of H. pylori, mainly due to the increase in antibiotic resistance.
Secondly, the eradication rate decreased, but effectiveness remained higher with the alternative regimen (90% vs. 88%). Finally, in patients who received successive rescue treatments, from third to sixth line, it was observed that the effectiveness of both regimens was similar (85.5% for the regimen of 4 capsules 3 times a day versus 86% for the regimen of 4 capsules 3 times a day. regimen of 3 capsules 4 times a day).
Regarding the safety of scBQT, 995 patients (27%) presented at least one adverse effect, the most frequent being nausea, diarrhea and fatigue. No statistically significant differences were observed between the two treatment regimens evaluated. Adherence to treatment was very high (approximately 97%) and similar with both regimens.
Finally, the authors conclude by recommending the use of the alternative regimen of 4 capsules 3 times a day instead of the traditional regimen of 3 capsules 4 times a day, since the former is more effective, especially in first-line eradication treatments. This collaborative study has been published in the journal Gut. “The results of this study indicate that the alternative regimen is even more effective than the traditional regimen,” the research team assured.
