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- Title
Efficacy and Cost-Effectiveness of Helicobacter pylori Eradication: Comparison of Tailored Therapy Based on Clarithromycin Resistance and Concomitant Therapy.
- Authors
Kyungeun Lim; Moonkyung Joo; Jongjae Park; Beomjae Lee; Seunghan Kim; Hoonjai Chun; Sangwoo Lee; Wonsik Kim; Ahyoung Yoo; Seongmin Kim; Yeonho Lee; Sangyoon Lim; Changheon Yang
- Abstract
Background/Aims The Helicobacter pylori eradication rate using conventional triple therapy has decreased due to clarithromycin resistance. Concomitant therapy or tailored therapy based on dual priming oligonucleotide (DPO)-based multiplex polymerase chain reaction (PCR) is considered as alternative first-line eradication strategies. We aimed to evaluate the eradication rate and cost-effectiveness of concomitant and tailored therapy. Methods Data from H. pylori-positive patients were collected between January 2017 and June 2019. The tailored therapy group underwent DPO-PCR testing; if DPO-PCR positive, 7-day bismuth-containing quadruple regimen were given, and if negative, 14-day conventional triple regimen was prescribed. In concomitant therapy group, 14-day concomitant regimen was prescribed. The cost-effectiveness of evaluated according to the average cost per patient and the incremental cost-effectiveness ratio. Results A total of 200 patients were allocated to the concomitant therapy group and 100 patients to the tailored therapy group. The eradication rate of first-line regimen was marginally higher in tailored therapy group than concomitant therapy group (179/200, 89.5% vs 96/100, 96.0%; p=0.055). The average costs per patient for tailored therapy were ₩591562.56 and ₩573304.30 for first-line and second-line treatments, respectively. Compared with concomitant therapy, the incremental cost-effectiveness ratios of tailored therapy were -₩31118.44 and -₩49376.70 per patient for first-line and second-line treatments, respectively. Conclusions Tailored therapy using DPO-PCR shows tendency of higher eradication rate cost-effectiveness compared with concomitant therapy. Larger scale, randomized trial may be necessary in the future.
- Subjects
HELICOBACTER pylori; CLARITHROMYCIN; COST effectiveness; POLYMERASE chain reaction
- Publication
Gut & Liver, 2019, Vol 13, Issue 6(suppl. 1), p13
- ISSN
1976-2283
- Publication type
Article