Modified Pylobact AM based therapy

B.D. Starostin

Saint Petersburg Outpatient Clinic No. 38

The feasibility and need for H. pylori eradication are out of question and are recommended in numerous recommendations of recent years. In most countries, there has been a significant decrease in the 7-day standard triple therapy effectiveness. Eradication under the most frequently used anti-helicobacter regimens is also not achieved.

Aim: to study the effectiveness of a 14-day modified Pylobact AM based therapy (MPAMBT) compared to a 7-day standard Pylobact AM based therapy (SPAMBT) and known meta-analysis data of targeted therapy.

Patients and Methods: the two-center controlled multifactorial study was conducted under specially developed protocol in accordance with good clinical practice (GCP) standards. Group 1 (n=201) consisted of patients who received MPAMBT, and group 2 (n=15) — patients who received SPAMBT.

Results: eradication indicators were the following: in group 1 — 95% intention to treat (ITT) and 96% per protocolum (PP), and in group 2 — 53% (ITT) and 57 % (PP). Eradication indicators during targeted therapy were M_cp=87.6% (ITT) and 92.2% (PP) according to meta-analysis. H. pylori eradication rates after MPAMBT significantly exceeded those after SPAMBT and were not inferior to targeted therapy. Adverse events were 2 times less frequently detected during MPAMBT than during SPAMBT.

Conclusion: MPAMBT can be recommended for front-line therapy. MPAMBT is a highly effective and safe option for the treatment of diseases associated with H. pylori. Also, MPAMBT eliminates the need for additional researches aimed at determining the sensitivity of H. pylori and PPI metabolism, reducing costs and speeding up the prescription of etiopathogenetic therapy. Besides, MPAMBT is not inferior to targeted therapies during which antibiotic sensitivity and/or genotypic polymorphism СУР2С19 is taking into account.

Keywords: modified Pylobact AM based therapy, standard Pylobact AM-based therapy, targeted therapy, Helicobacter pylori, eradication.

For citation: Starostin B.D. Modified Pylobact AM based therapy. RMJ. 2019;5:8–12.