Hybrid Therapy versus Sequential Therapy for Eradication of Helicobacter pylori: A Randomized Controlled Trial

Area of Science:

• Gastroenterology
• Infectious Diseases
• Pharmacology

Background:

• Peptic ulcer disease and gastritis are often caused by Helicobacter pylori infection.
• Effective eradication of H. pylori is crucial for managing these conditions and preventing recurrence.

Purpose of the Study:

• To compare the efficacy of hybrid therapy (HT) versus sequential therapy (ST) for H. pylori eradication.
• To evaluate eradication rates, patient compliance, and complications associated with both therapeutic regimens.

Main Methods:

• A randomized controlled trial involving 120 patients with H. pylori positive peptic ulcer disease or gastritis.
• Patients were assigned to either HT (omeprazole, amoxicillin, clarithromycin, metronidazole) or ST (omeprazole, amoxicillin, clarithromycin, metronidazole) with different treatment durations and sequences.
• Eradication rates were assessed using intention-to-treat and per-protocol analyses.

Main Results:

• Hybrid therapy demonstrated a significantly higher H. pylori eradication rate (88.3%) compared to sequential therapy (73.3%) in intention-to-treat analysis (P=0.037).
• Per-protocol analysis also favored HT, though the difference was not statistically significant (93% vs. 81.5%).
• Patient compliance and the incidence of side effects were comparable between the two groups. HT incurred a higher cost ($10.77) than ST ($6.347).

Conclusions:

• Hybrid therapy provides superior H. pylori eradication rates compared to sequential therapy.
• Despite a higher cost, HT can be considered for H. pylori eradication, especially in regions where ST proves less effective.
• Both therapies exhibit similar safety profiles and patient compliance.