Safety of first-line triple therapy with a potassium-competitive acid blocker for Helicobacter pylori eradication in children

被引:42
|
作者
Kusano, Chika [1 ,2 ]
Gotoda, Takuji [1 ]
Suzuki, Sho [1 ,2 ]
Ikehara, Hisatomo [1 ,2 ]
Moriyama, Mitsuhiko [1 ]
机构
[1] Nihon Univ, Sch Med, Dept Med, Div Gastroenterol & Hepatol,Chiyoda Ku, 1-6 Kanda Surugadai, Tokyo, Japan
[2] Yuri Kumiai Gen Hosp, Div Gastroenterol, Akita, Japan
关键词
Children; Helicobacter pylori; Potassium-competitive acid blocker; RANDOMIZED CONTROLLED-TRIAL; GASTRIC-CARCINOMA; MONOFUMARATE TAK-438; BREATH TEST; INFECTION; CANCER; RISK; METAANALYSIS; DIAGNOSIS; JAPAN;
D O I
10.1007/s00535-017-1406-2
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background Helicobacter pylori infection is a risk factor for gastric cancer, and it has been reported that eradication of H. pylori is effective for preventing such cancer. Recently, H. pylori eradication has been performed in children as first-line therapy against gastric cancer. Here, we report use of triple therapy with a potassium-competitive acid blocker (P-CAB) for H. pylori eradication in children. Methods H. pylori infection testing and eradication therapy began in fiscal year 2015 in junior high school students located in Yurihonjo city and Nikaho city, Akita prefecture, Japan. Urine-based immunochromatography, stool antigen enzyme-linked immunosorbent assay tests, and serum antibody tests were performed as the initial screening examination. Those who tested positive on one of the three examinations then underwent a urea breath test (13 CUBT). Those who tested positive on 13 C-UBT and expressed the desire to undergo H. pylori eradication then received eradication therapy comprising 20 mg P-CAB, 750 mg amoxicillin, and 200 mg clarithromycin twice a day for 7 days. At least 8 weeks after treatment, eradication success was evaluated using 13 C-UBT. Results A total of 118 students received eradication therapy. Eradication rates were 81.3% (95% confidence interval: 74.3-88.4, 96/118) in ITT analysis and 85.7% (95% confidence interval: 79.1-92.9 96/ 112) in PP analysis. Adverse effects associated with eradication therapy were observed in 25 of 118 subjects (21.1%), seven of whom required hospital treatment (rash in five, vomiting in two). All seven subjects either discontinued therapy or were administered anti-allergy drugs, which resulted in swift alleviation of symptoms. Conclusions First-line triple therapy with a P-CAB for H. pylori eradication in children was found to be safe.
引用
收藏
页码:718 / 724
页数:7
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