针对成年人耐火性Helicobacter pylori感染的新疗法:系统性审查
Ligang Liu1, Milap C Nahata1,2
1Institute of Therapeutic Innovations and Outcomes (ITIO), College of Pharmacy, The Ohio State University, Columbus, OH 43210, USA.
较新的治疗方法,如高剂量双疗法,诺普拉桑和利法布丁,为抵抗初始治疗的Helicobacter pylori (H. pylori) 感染提供了有效的救援选择. 这些方案显示了高根除率与可管理的安全概况.
科学领域:
- 胃肠病学 胃肠病学
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 杆菌 (H. pylori) 感染影响了全球三分之二的人口.
- 标准的H. pylori根除疗法经常失败,需要有效的救援策略.
研究的目的:
- 评估新型治疗方案的疗效和安全性,以消除先前治疗失败的患者的H. pylori.
- 为了比较基于vonoprazan的治疗,高剂量的PPI-阿莫西西林双疗法 (HDDT) 和含有里法布丁的三重疗法作为救援选择.
主要方法:
- 在PubMed,Cochrane图书馆和Embase进行了系统的文献搜索.
- 包括2010年以后发表的随机对照试验 (RCT),重点关注H. pylori治疗失败的患者.
主要成果:
- 尽管出现了更多的不良事件,但HDDT实现了高根除率 (81.389.2%),与甲尼达 (92.6%) 结合时有效性提高.
- 基于诺普拉桑的疗法表现出与基于PPI的疗法具有类似不良事件的可比或更高的根除率 (83.389.5%).
- 含利法布丁的三重疗法显示出高疗效 (80.7100%),特别是在多次治疗的患者中,并且相比斯木疗法更少的不良事件.
结论:
- 高剂量双重治疗,基于诺普拉桑的治疗和基于利法布丁的治疗是对H. pylori感染的有效和安全的救援选择.
- 需要进一步进行大规模的RCT来优化剂量和持续时间,以便在耐火病例中最大限度地消除和最小限度的不良事件.
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