AUTHOR=Cheng Jianping , Fan Chanjuan , Huang Kun , Zhai Lili , Wang Hui , Xie Dongling , Cai Yong , Li Zhen , Bai Qixuan , Wang Pan , Ding Haiou 

TITLE=Efficacy and safety of high-dose ilaprazole-amoxicillin dual therapy for Helicobacter pylori eradication: a prospective, single-center, randomized trial

JOURNAL=Frontiers in Pharmacology

VOLUME=14

YEAR=2023

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2023.1272744

DOI=10.3389/fphar.2023.1272744

ISSN=1663-9812

ABSTRACT=<p><bold>Background:</bold> Until now, there have been no randomized controlled trials directly evaluating the efficacy of high-dose ilaprazole-amoxicillin dual therapy (HT) in comparison to other standard treatments for <italic>H. pylori</italic> (<italic>Helicobacter pylori</italic>) infection. This study aimed to compare the effectiveness and safety of HT with bismuth quadruple therapy (BQT) as an initial treatment for <italic>H. pylori</italic>.</p><p><bold>Methods:</bold> This single-center, prospective, randomized clinical controlled trial recruited 225 consecutive patients. They were assigned to either HT group (ilaprazole, 10 mg, twice daily; amoxicillin 1,000 mg, three times daily) or BQT group (compound bismuth aluminate granules, 2.6 g, three times daily; ilaprazole, 5 mg, twice daily; amoxicillin, 1,000 mg, twice daily; clarithromycin, 500 mg, twice daily) for 14 days. The <sup>13</sup>C-urea breath test assessed eradication success 4 weeks after treatment. The primary outcome focused on the eradication rate, with secondary outcomes including safety and compliance.</p><p><bold>Results:</bold> From February 2023 to March 2023, 228 subjects were screened, and 225 were randomized. The HT and BQT groups showed eradication rates of 76.3% and 61.3% (<italic>p</italic> = 0.015) both by intention-to-treat (ITT) analysis and per-protocol (PP) analysis. HT was associated with fewer adverse events than BQT (27.2% vs. 81.8%, <italic>p</italic> = 0.002). The most commonly reported adverse events was bitter taste of mouth (3.5% vs. 60.4%, <italic>p</italic> &lt; 0.001). There was no significant difference in compliance between the two groups (89.5% vs. 92.8%, <italic>p</italic> = 0.264).</p><p><bold>Conclusion:</bold> The 14-day HT treatment demonstrates better efficacy in <italic>H. pylori</italic> eradication treatment and improved safety and compliance compared to BQT. The results provide supporting evidence for 14-day HT can be potentially considered as a first-line regimen for empirical treatment.</p><p><bold>Clinical Trial Registration:</bold><ext-link ext-link-type="uri" xlink:href="https://www.chictr.org.cn/showproj.html?proj=186562" xmlns:xlink="http://www.w3.org/1999/xlink">https://www.chictr.org.cn/showproj.html?proj=186562</ext-link>, identifier ChiCTR2200066284</p>