Optimised empiric triple and concomitant therapy forHelicobacter pylorieradication in clinical practice: the OPTRICON study

• DOI: 10.1111/apt.13069
• Publication Date: 2015-01-14T15:29:01Z
• Authors: J. Molina-Infante; A. J. Lucendo; T. Angueira; M. Rodriguez-Tellez; A. Perez-Aisa; A. Balboa; J. Barrio; E. Martin-Noguerol; B. J. Gomez-Rodri...; J. M. Botargues-Bote; J. Gomez-Camarero; A. Huerta; I. Modolell; I. Ariño; M. T. Herranz-Bac...; F. Bermejo; A. G. McNicholl; C. O'Morain; J. P. Gisbert
• Keywords: Esomeprazole; Concomitant

Background Empiric triple therapy for Helicobacter pylori should be abandoned when clarithromycin resistance rate is >15–20%. Optimisation of (high-dose acid suppression and 14-day duration) can increase eradication rates by 10%. Aim To compare the efficacy safety optimised (OPT-TRI) nonbismuth quadruple concomitant (OPT-CON) therapies. Methods Prospective multicentre study in 16 Spanish centres using clinical practice. In a 3-month two-phase fashion, first 402 patients received an OPT-TRI [esomeprazole (40 mg b.d.), amoxicillin (1 g b.d) (500 14 days] last 375 OPT-CON treatment [OPT-TRI plus metronidazole b.d)]. Results Seven-hundred seventy-seven consecutive were included (402 OPT-TRI, OPT-CON). The achieved significantly higher per-protocol [82.3% (95% CI = 78–86%) vs. 93.8% (91–96%), P < 0.001] intention-to-treat analysis [81.3% (78–86%) 90.4% (87–93%), 0.001]. Adverse events (97% mild/moderate) more common with (39% 47%, 0.016), but full compliance was similar between groups (94% 92%, 0.4). only significant predictor successful (odds ratio, 2.24; 95% CI: 1.48–3.51, 0.001). participating achieving cure ≥90% favoured (OPT-TRI 25% 62%). Conclusions (>90%) compared to therapy. Addition increased 10%, resulting mild adverse effects, without impairing