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  • Korean College of Helicobacter and Upper Gastrointestinal Research  (4)
  • Kim, Sung Eun  (4)
  • Park, Seon-Young  (4)
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  • Korean College of Helicobacter and Upper Gastrointestinal Research  (4)
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  • 1
    Online Resource
    Online Resource
    A 10- or 14-day Bismuth-containing Quadruple Therapy as a First-line Helicobacter pylori Eradication Therapy: A Systematic Review and Meta-analysis
    Korean College of Helicobacter and Upper Gastrointestinal Research ; 2021
    In:  The Korean Journal of Helicobacter and Upper Gastrointestinal Research Vol. 21, No. 1 ( 2021-03-10), p. 48-58
    Details
    In: The Korean Journal of Helicobacter and Upper Gastrointestinal Research, Korean College of Helicobacter and Upper Gastrointestinal Research, Vol. 21, No. 1 ( 2021-03-10), p. 48-58
    Abstract: Background/Aims: The eradication rate of the first-line standard triple therapy (STT) for 〈 i 〉 Helicobacter pylori 〈 /i 〉 ( 〈 i 〉 H. pylori 〈 /i 〉 ) infection has decreased since 2000; therefore, other first-line therapies are required. This study was aimed at investigating the efficacy of bismuth-containing quadruple therapy (PBMT) for first-line 〈 i 〉 H. pylori 〈 /i 〉 eradication compared to STT, sequential therapy (SQT), and concomitant therapy (CT).Materials and Methods: The Ovid-MEDLINE, Koreamed, EMBASE, KMBASE, and Cochrane Library databases were searched from January 2008 to July 2018. All identified randomized controlled trials (RCTs) comparing PBMT and non-PBMT for first-line 〈 i 〉 H. pylori 〈 /i 〉 eradication therapy were included in the final analysis.Results: A total of 3,653 patients from seven RCTs were enrolled. The pooled eradication rates of PBMT by intention-to-treat (ITT) and per-protocol (PP) analyses were 82.1% (95% CI, 68.2~90.8%) and 88.8% (95% CI, 77.1~94.9%), respectively. However, no statistically significant difference was observed in eradication rates of the 10- or 14-day PBMT as compared to 14-day STT, 10-day SQT, and 10-day CT in ITT and PP analyses. PBMT was significantly higher in adverse events than in the other eradication regimens (RR, 1.64; 95% CI, 1.11~2.44). Considerable heterogeneity in adverse events was observed among studies (χ 〈 sup 〉 2 〈 /sup 〉 =88.7; 〈 i 〉 P 〈 /i 〉 〈 0.001, I 〈 sup 〉 2 〈 /sup 〉 =93%).Conclusions: PBMT can be the first-line treatment for 〈 i 〉 H. pylori 〈 /i 〉 eradication in Korea when other first-line options, including STT, SQT, or CT, are unavailable due to their high adverse event rates.
    Type of Medium: Online Resource
    ISSN: 1738-3331 , 2671-826X
    URL: Article
    DOI: 10.7704/kjhugr.2020.0052
    Language: English
    Publisher: Korean College of Helicobacter and Upper Gastrointestinal Research
    Publication Date: 2021
    detail.hit.zdb_id: 3071420-5
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    Online Resource
  • 2
    Online Resource
    Online Resource
    Evidence-based Guidelines for the Treatment of Helicobacter pylori Infection in Korea: 2020 Revised Edition
    Korean College of Helicobacter and Upper Gastrointestinal Research ; 2020
    In:  The Korean Journal of Helicobacter and Upper Gastrointestinal Research Vol. 20, No. 4 ( 2020-12-10), p. 261-287
    Details
    In: The Korean Journal of Helicobacter and Upper Gastrointestinal Research, Korean College of Helicobacter and Upper Gastrointestinal Research, Vol. 20, No. 4 ( 2020-12-10), p. 261-287
    Abstract: Helicobacter pylori (H. pylori) infection is one of the most common infectious diseases worldwide. Although its incidence is gradually decreasing, about half of the world's population still get infected. H. pylori infection is responsible for substantial gastrointestinal morbidity worldwide. It is the most common cause of gastric and duodenal ulcers as well as gastric cancer. Since the revision of the H. pylori Clinical Practice Guidelines in 2013, the eradication rate of H. pylori has gradually decreased with the use of classical triple therapy, wherein amoxicillin, clarithromycin, and proton pump inhibitors are administered, for 7 days. According to a nationwide randomized controlled study conducted by the Korean College of Helicobacter and Upper Gastrointestinal Research released in 2018, the intention-to-treat eradication rate was only 63.9%, which was due to increased antimicrobial resistance induced by the use of antibiotics, especially clarithromycin. The update of clinical practice guideline for treatment of H. pylori was developed based on evidence-based medicine by conducting a meta-analysis. The draft recommendations were finalized after expert consensus on three recommendations regarding the indication for treatment and eight recommendations on the treatment itself. These guidelines are designed to provide patients, nurses, medical school students, policymakers, and clinicians with clinical evidence to guide primary care and treatment of H. pylori infection. These may differ from current medical insurance standards and will be revised further, if necessary, based on research-based evidence.
    Type of Medium: Online Resource
    ISSN: 1738-3331 , 2671-826X
    URL: Article
    DOI: 10.7704/kjhugr.2020.0045
    Language: English
    Publisher: Korean College of Helicobacter and Upper Gastrointestinal Research
    Publication Date: 2020
    detail.hit.zdb_id: 3071420-5
    Location Call Number Limitation Availability
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    Online Resource
  • 3
    Online Resource
    Online Resource
    Salvage Regimens after Failure of Previous Helicobacter pylori Eradication Therapy: A Systematic Review and Meta-analysis
    Korean College of Helicobacter and Upper Gastrointestinal Research ; 2021
    In:  The Korean Journal of Helicobacter and Upper Gastrointestinal Research Vol. 21, No. 1 ( 2021-03-10), p. 59-71
    Details
    In: The Korean Journal of Helicobacter and Upper Gastrointestinal Research, Korean College of Helicobacter and Upper Gastrointestinal Research, Vol. 21, No. 1 ( 2021-03-10), p. 59-71
    Abstract: Background/Aims: As antibiotic resistance increases and new first-line therapies emerge, salvage therapies for 〈 i 〉 Helicobacter pylori 〈 /i 〉 ( 〈 i 〉 H. pylori 〈 /i 〉 ) eradication failures are becoming more common and complicated. This study aimed to systematically review overall salvage regimens after previous failure of 〈 i 〉 H. pylori 〈 /i 〉 eradication.Materials and Methods: A systematic review of randomized clinical trials evaluating salvage therapies after previous 〈 i 〉 H. pylori 〈 /i 〉 eradication failure was performed. A meta-analysis was conducted when an adequate number of studies suitable for grouping was found.Results: Overall, 36 studies with 77 treatment arms were identified, and they were highly heterogeneous regarding previously failed regimens and salvage regimens under comparison. Bismuth quadruple therapy after failure of standard triple therapy showed a pooled intention-to-treat (ITT) eradication rate of 75.5% (95% CI, 71.6~79.1%), and the rates were significantly higher with 14-day therapy than 7-day therapy by 9% (95% CI, 2~15%). Levofloxacin triple therapy after failure of standard triple therapy demonstrated a pooled ITT eradication rate of 73.3% (95% CI, 68.4~77.3%). In direct comparison, the two regimens were not significantly different in eradication rates. No study evaluated salvage regimens after the failure of bismuth or non-bismuth quadruple therapy.Conclusions: The current studies regarding salvage regimens are highly heterogeneous. Bismuth quadruple therapy and levofloxacin triple therapy may be a reliable option after failure of standard triple therapy, but the regional profile of antibiotic resistance should be considered. Further studies are needed for salvage regimens after failure of non-bismuth or bismuth quadruple therapy.
    Type of Medium: Online Resource
    ISSN: 1738-3331 , 2671-826X
    URL: Article
    DOI: 10.7704/kjhugr.2020.0053
    Language: English
    Publisher: Korean College of Helicobacter and Upper Gastrointestinal Research
    Publication Date: 2021
    detail.hit.zdb_id: 3071420-5
    Location Call Number Limitation Availability
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    Online Resource
  • 4
    Online Resource
    Online Resource
    Eradication Rates of Clarithromycin Triple Therapy in Korea: A Systematic Review and Meta-analysis
    Korean College of Helicobacter and Upper Gastrointestinal Research ; 2021
    In:  The Korean Journal of Helicobacter and Upper Gastrointestinal Research Vol. 21, No. 1 ( 2021-03-10), p. 35-47
    Details
    In: The Korean Journal of Helicobacter and Upper Gastrointestinal Research, Korean College of Helicobacter and Upper Gastrointestinal Research, Vol. 21, No. 1 ( 2021-03-10), p. 35-47
    Abstract: Background/Aims: Standard triple therapy, including a proton pump inhibitor, clarithromycin, and amoxicillin, has been recommended as the first-line for 〈 i 〉 Helicobacter pylori 〈 /i 〉 infection. However, the eradication rate of standard triple therapy has declined over the past years because of the increasing resistance to clarithromycin in Korea. We analyzed the eradication rates and the 10-year change in the eradication rates in Korea.Methods: PubMed, EMBASE, the Cochrane Library, and KoreaMed were searched for studies published between January 2007 and June 2018. The pooled eradication rates and their 95% CIs were estimated using a random-effect logistic regression model.Results: Twenty-six randomized controlled studies on standard triple therapy conducted in Korea were selected. The intention-to-treat (ITT) and per protocol analyses showed pooled eradication rates of standard triple therapy of 71.6% (95% CI, 69.9~73.3%) and 79.6% (95% CI, 76.6~82.2%), respectively. The eradication rate decreased with time. The ITT analysis showed that the 14-day therapy (78.1% [95% CI, 75.2~80.7%]) had significantly higher eradication rates than the 7-day therapy (70.0% [95% CI, 68.5~71.4%] ) ( 〈 i 〉 P 〈 /i 〉 〈 0.01).Conclusions: These results suggest that the eradication rate of standard triple therapy, as the first-line therapy, has shown an unacceptable decrease. The eradication rate increased when the duration of therapy was increased to 14 days, but it was not satisfactory. Therefore, other treatment regimens or therapies based on susceptibility tests should be considered for the first-line therapy.
    Type of Medium: Online Resource
    ISSN: 1738-3331 , 2671-826X
    URL: Article
    DOI: 10.7704/kjhugr.2020.0056
    Language: English
    Publisher: Korean College of Helicobacter and Upper Gastrointestinal Research
    Publication Date: 2021
    detail.hit.zdb_id: 3071420-5
    Location Call Number Limitation Availability
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    Online Resource
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