Comprehensive Analysis of Factors Associated With Eradication Therapy

Abstract

Objectives Associated factors for the failure of Helicobacter pylori (HP) eradication have been evaluated in many studies; however, the different study population of previous studies prevents us from understanding the comparative risk between factors. We aimed to comprehensively investigate factors associated with successful HP eradication based on a single study population. Methods We retrospectively reviewed the medical records of adults diagnosed with HP infection between March 2021 and October 2022 at Hanyang University Guri Hospital. The study categorized eradication treatment methods based on the type of acid blockers (proton pump inhibitor [PPI] or potassium-competitive acid blocker [P-CAB]), antibiotic combination, and treatment duration. Demographics and clarithromycin-resistance mutation status were also considered as potential factors of HP eradication. Results A total of 554 patients who received first-line HP eradication therapy were included. In the full-analysis set, the eradication rates according to the regimen were as follows: 7-day tegoprazan-based triple, 61.6%; 14-day tegoprazan-based triple, 77.5%; 14-day rabeprazole-based triple, 71.1%; 10-day rabeprazole-based concomitant, 73.1%; 10-day tegoprazan-based concomitant, 80.5%. The 14-day triple and 10-day concomitant therapies showed a superior eradication rate to the 7-day triple therapy regardless of the type of acid blockers (PPI or P-CAB). Additionally, clarithromycin-resistance mutation was the strongest predictor for eradication failure (hazard ratio 9.86 [95% confidence interval, 2.07–46.97]). Conclusions The 14-day triple and 10-day concomitant therapy was superior to the 7-day triple therapy regardless of PPI or P-CAB use. However, clarithromycin-resistance mutation status was a more powerful predictor for HP eradication than the type of antibiotics and treatment duration.

Keywords

• proton pump inhibitor
• potassium-competitive acid blocker
• antibiotics resistance