AUTHOR=Niu Min , Zhou Yan , Xie Yunqian , Li Xue , Tian Yonggang , Yao Li , Li Ximei , Gao Hengjun , Bai Feihu 

TITLE=Comparison of the Dual Therapy of Ilaprazole-Amoxicillin and the Bismuth Quadruple Therapy of Ilaprazole-Amoxicillin-Furazolidone-Bismuth Glycyrrhizinate for Eradication of Helicobacter pylori

JOURNAL=Frontiers in Pharmacology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2022.771876

DOI=10.3389/fphar.2022.771876

ISSN=1663-9812

ABSTRACT=Objective: The present study aims to compare the safety and efficacy of an amoxicillin/eprazole regimen with a bismuth quadruple regimen as the first-line treatment for eradicating Helicobacter pylori (H. pylori) infection. 
Methods: This was an open-label, randomized, single-center study involving 450 patients with untreated H. pylori infection who were randomly assigned to an Ilaprazole-based bismuth quadruple therapy group for 14 days, a bismuth quadruple therapy group for 10 days, or a proton pump inhibitor (PPI)-amoxicillin dual therapy group for 14 days. The 13C urea breath test determined that H. pylori had been eliminated 4–6 weeks after treatment. For patients who failed the first treatment, mucosal tissues (two gastric antrum and one gastric body) were taken under gastroscope for the culture of H. pylori, drug sensitivity, the CYP2C19 gene, and globular degeneration. 
Results: In the intention-to-treat analysis, the eradication rates of H. pylori in the EAFB-14-day group, the EAFB-10-day group, and the EA-14-day group were 84.0%, 79.3%, and 88.0%, respectively. In the adherence-to-study protocol analysis, the eradication rates in the three groups were 94.7%, 87.5%, and 93.0%, respectively. The resistance rates of H. pylori were 68.9% (22/32) for amoxicillin, 90.6% (29/32) for clarithromycin, 68.9% (22/32) for metronidazole, and 87.5% (28/32) for levofloxacin. The extensive metabolizers of CYP2C19 polymorphism were 59.3% (19/32), the intermediate metabolizers were 34.4% (11/32), and the poor metabolizers were 6.3% (2/32). 
Conclusion: For newly treated patients with H. pylori infection in China, the efficacy of Ilaprazole-based 14 days therapy and bismuth quadruple therapy for 10 or 14 days was shown to be equivalent, with good compliance and a lower cost. Therefore, these therapies can be considered first-line regimens for empirical treatment.