Modified sequential therapy vs quadruple therapy as initial therapy in patients with Helicobacter infection

Area of Science:

• Gastroenterology
• Infectious Diseases
• Pharmacology

Background:

• Helicobacter pylori (H. pylori) infection is a major cause of chronic gastritis and peptic ulcer disease.
• Effective eradication therapies are crucial to prevent complications and reduce recurrence.
• Novel therapeutic strategies, including modified sequential therapy, are continuously being evaluated.

Purpose of the Study:

• To assess the efficacy and safety of a modified sequential therapy regimen.
• To compare the outcomes of modified sequential therapy with standard quadruple therapy for H. pylori eradication.

Main Methods:

• A randomized study involving 200 patients with H. pylori-infected chronic gastritis.
• Group A received ilaprazole-based standard quadruple therapy; Group B received a 10-day modified sequential therapy.
• H. pylori eradication was confirmed using the 14C-urea breath test; intention-to-treat and per-protocol analyses were performed.

Main Results:

• Intention-to-treat eradication rates were 85.15% for standard quadruple therapy and 81.82% for modified sequential therapy.
• Per-protocol eradication rates were 88.66% and 87.09%, respectively, with no significant difference between groups (P = 0.741).
• Adverse event rates were similar (6.19% vs. 7.53%), and no major morbidities were observed.

Conclusions:

• Ilaprazole-based 10-day standard quadruple therapy offers no significant incremental benefit over modified sequential therapy.
• Both regimens are effective, safe, and well-tolerated initial treatment options for H. pylori infection.
• The findings support the use of modified sequential therapy as a viable alternative for H. pylori eradication.