Brief communication: global temporal trends in the efficacy of clarithromycin-based regimens for the treatment of Helicobacter pylori infection

Author:

Moss Steven F.1,Chey William D.2,Daniele Patrick3,Pelletier Corey4,Jacob Rinu4,Tremblay Gabriel3,Hubscher Elizabeth3,Leifke Eckhard4,Malfertheiner Peter56

Affiliation:

1. Division of Gastroenterology, Alpert Medical School of Brown University, 222 Richmond St, Providence, RI 02903, USA

2. Division of Gastroenterology, University of Michigan Health System, Ann Arbor, MI, USA

3. Cytel, Inc., Waltham, MA, USA

4. Phathom Pharmaceuticals, Florham Park, NJ, USA

5. Department of Gastroenterology, Hepatology and Infectious Diseases, Otto von Guericke University, Magdeburg, Germany

6. LMU Medizinische Klinik und Poliklinik II, Muenchen, Germany

Abstract

Background: Helicobacter pylori eradication rates achieved with clarithromycin-based triple therapies are declining due to antibiotic resistance, but data regarding temporal changes in efficacy with these eradication therapies are scarce. Objective: To evaluate the efficacy of clarithromycin-based triple eradication regimens over time. Design: A comprehensive literature review and time-trend analysis. Data sources and methods: Bibliographies of recently published systematic literature reviews were searched and supplemented with a targeted literature review conducted using Medline and Embase databases and ProQuest from conception to May 2021. Studies reporting H. pylori eradication rates of clarithromycin-based triple therapies were included and temporal trends were estimated using a random-effects model. Results: Eradication rates for triple therapies containing proton pump inhibitors (PPIs), clarithromycin, and amoxicillin showed a significant decline over the past 23 years ( p = 0.0315). However, this decline was not significant when eradication rates achieved with vonoprazan-based triple therapy were included ( p = 0.3910). Conclusion: Vonoprazan-based triple therapy partially mitigated the decline in eradication rates seen with PPI-based triple therapy, likely due to more powerful acid suppression of vonoprazan.

Funder

Phathom Pharmaceuticals

Publisher

SAGE Publications

Subject

Gastroenterology

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