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- Title
Trends of Second-Line Eradication Therapy for Helicobacter pylori in Japan: A Multicenter Study in the Tokyo Metropolitan Area.
- Authors
Asaoka, Daisuke; Nagahara, Akihito; Matsuhisa, Takeshi; Takahashi, Shin‐ichi; Tokunaga, Kengo; Kawai, Takashi; Kawakami, Kohei; Suzuki, Hidekazu; Suzuki, Masayuki; Nishizawa, Toshihiro; Kurihara, Naoto; Ito, Masayoshi; Sasaki, Hitoshi; Omata, Fumio; Mizuno, Shigeaki; Torii, Akira; Ohkusa, Toshifumi; Mine, Tetsuya; Sakaki, Nobuhiro
- Abstract
Background In Japan, the eradication rate of first-line therapy for Helicobacter pylori ( H. pylori) with a proton pump inhibitor ( PPI), amoxicillin ( AMPC) and clarithromycin ( CAM) has been decreasing because of a high prevalence of CAM resistance. A possible decrease of the eradication rate for second-line therapy with a PPI, AMPC and metronidazole ( MNZ) is of concern. The aim of this study is to assess the trends in second-line eradication therapy for H. pylori in Japan. Materials and Methods We accumulated data retrospectively on patients administered second-line eradication therapy for Helicobacter pylori with a PPI, AMPC, and MNZ for 1 week after failure of first-line eradication therapy with a PPI, AMPC and CAM at 15 facilities in the Tokyo metropolitan area in Japan from 2007 to 2011. Trends for second-line eradication rates in modified intention-to-treat ( ITT) analyses were investigated. Second-line eradication rates were categorized by three PPIs (rabeprazole ( RPZ), lansoprazole ( LPZ) or omeprazole ( OMZ)) and evaluated. Results We accumulated data on 1373 patients. The overall second-line eradication rate was 92.4%. Second-line eradication rates in 2007, 2008, 2009, 2010 and 2011 were 97.7, 90.6, 94.5, 91.8 and 91.8%, respectively, with no significant trends revealed. Second-line eradication rates categorized by three PPIs for the entire 5-year period were 91.6, 93.4 and 92.4% ( RPZ, LPZ and OPZ, respectively) with no significant differences among the three PPIs. Conclusions From 2007 to 2011, there were no significant trends in the second-line eradication rates and the rates remained consistently high. From the viewpoint of high prevalence of CAM resistance in Japan, triple therapy with PPI, AMPC and MNZ may be a better strategy for first-line therapy compared to triple therapy with PPI, AMPC and CAM.
- Subjects
HELICOBACTER pylori; PROTON pump inhibitors; AMOXICILLIN; CLARITHROMYCIN; METRONIDAZOLE; LANSOPRAZOLE
- Publication
Helicobacter, 2013, Vol 18, Issue 6, p468
- ISSN
1083-4389
- Publication type
Article
- DOI
10.1111/hel.12063