The effectiveness of eradication therapy of the 1st line of Helicobacter pylori infection in patients with type 2 diabetes mellitus

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Abstract

Aim. Evaluation of the efficacy and safety of eradication therapy of infection Helicobacter pylori in patients with H. pylori- associated pathology of the upper gastrointestinal tract and concomitant type 2 diabetes mellitus (DM).

Materials and methods. The prospective randomized study involving 180 patients (87 men and 93 women) with H. pylori- associated pathology of the upper gastrointestinal tract was carried out. The patients were divided into four groups of 45 people: 1 – patients without diabetes who received the classic triple eradication therapy; 2 – patients with type 2 DM who received the classic triple eradication therapy; 3 – patients without DM who underwent quadrotherapy with bismuth preparations; 4 – patients with type 2 DM who underwent quadrotherapy with bismuth preparations. Eradication therapy was carried out for 14 days. Evaluation of the effectiveness of eradication using a breath test was carried out 4 weeks after completion of the course of treatment. Eradication success was assessed separately for ITT and PP analyzes.

Results. The effectiveness of classical triple eradication therapy in patients with concomitant type 2 DM is 64.4% in the ITT group and 69.05% in the PP: quadrotherapy 73.34 and 80.49%, respectively. The effectiveness of first line eradication therapy is higher in patients without DM compared with groups of patients with concomitant type 2 DM: ITT 83.33%, PP 88.23% and ITT 68.89%, PP 74.70%, respectively. The incidence of side effects in patients with type 2 DM: with the use of classical triple therapy 22.23%, quadrotherapy – 31.12%.

Conclusion. The data of the study of the efficacy and safety of line I eradication therapy make it possible to recommend the four-component therapy based on bismuth for use in clinical practice, especially in patients with DM.

About the authors

Igor V. Maev

Yevdokimov Moscow State University of Medicine and Dentistry

Email: dna-mit8@mail.ru
ORCID iD: 0000-0001-6114-564X

акад. РАН, д-р мед. наук, проф., зав. каф. пропедевтики внутренних болезней и гастроэнтерологии

Russian Federation, Moscow

Ashot M. Mkrtumyan

Yevdokimov Moscow State University of Medicine and Dentistry

Email: dna-mit8@mail.ru
ORCID iD: 0000-0003-1316-5245

д-р мед. наук, проф., зав. каф. эндокринологии и диабетологии

Russian Federation, Moscow

Luiza G. Bektemirova

Yevdokimov Moscow State University of Medicine and Dentistry

Email: dna-mit8@mail.ru
ORCID iD: 0000-0002-6932-0729

аспирант каф. пропедевтики внутренних болезней и гастроэнтерологии

Russian Federation, Moscow

Dmitry N. Andreev

Yevdokimov Moscow State University of Medicine and Dentistry

Author for correspondence.
Email: dna-mit8@mail.ru
ORCID iD: 0000-0002-4007-7112

канд. мед. наук, доц., доц. каф. пропедевтики внутренних болезней и гастроэнтерологии

Russian Federation, Moscow

Diana T. Dicheva

Yevdokimov Moscow State University of Medicine and Dentistry

Email: dna-mit8@mail.ru
ORCID iD: 0000-0001-9224-7382

канд. мед. наук, доц. каф. пропедевтики внутренних болезней и гастроэнтерологии

Russian Federation, Moscow

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Supplementary files

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2. Fig. 1. Study scheme.

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3. Fig. 2. Comparative effectiveness of eradication therapy depending on the presence of concomitant type 2 diabetes in the analysis of ITT and PP.

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4. Fig. 3. Comparative efficiency of 1st line eradication therapy by groups of patients in the analysis of ITT and PP.

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5. Fig. 4. The frequency of occurrence of side effects in groups receiving eradication therapy of the 1st line.

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