A large randomised controlled intervention trial to prevent gastric cancer by eradication of Helicobacter pylori in Linqu County, China: baseline results and factors affecting the eradication

作者：Pan, Kai-feng; Zhang, Lian; Gerhard, Markus; Ma, Jun-ling; Liu, Wei-dong; Ulm, Kurt; Wang, Jian-xi; Zhang, Lei; Zhang, Yang; Bajbouj, Monther; Zhang, Lan-fu; Li, Ming; Vieth, Michael; Liu, Rui-yong; Quante, Michael; Wang, Le-hua; Suchanek, Stepan; Zhou, Tong; Guan, Wei-xiang; Schmid, Roland; Classen, Meinhard; You, Wei-cheng^*

来源：Gut, 2016, 65(1): 9-18.

DOI：10.1136/gutjnl-2015-309197

• QUADRUPLE THERAPY
• HIGH-RISK
• BISMUTH BISKALCITRATE
• ANTIBIOTIC-RESISTANCE
• REFLUX ESOPHAGITIS
• TREATMENT FAILURE
• SIMPLE CLOSURE
• INFECTION
• OMEPRAZOLE
• ULCER

Objective To clarify the full range of benefits and adverse consequences of Helicobacter pylori eradication as a strategy for gastric cancer prevention, the community-based intervention trial was launched in Linqu County, China. @@@ Design A total of 184 786 residents aged 25-54 years were enrolled in this trial and received C-13-urea breath test. H. pylori positive participants were assigned into two groups, either receiving a 10-day quadruple anti-H. pylori treatment or lookalike placebos together with a single dosage of omeprazole and bismuth. @@@ Results The prevalence of H. pylori in trial participants was 57.6%. A total of 94 101 subjects completed the treatment. The overall H. pylori eradication rate was 72.9% in the active group. Gender, body mass index, history of stomach disease, baseline delta over baseline-value of C-13-urea breath test, missed medication doses, smoking and drinking were independent predictors of eradication failure. The missed doses and high baseline delta over baseline-value were important contributors in men and women (all P-trend<0.001). However, a dose-response relationship between failure rate and smoking or drinking index was found in men (all P-trend<0.001), while high body mass index (P-trend<0.001) and history of stomach disease were significant predictors in women. The treatment failure rate increased up to 48.8% (OR 2.87, 95% CI 2.24 to 3.68) in men and 39.4% (OR 2.67, 95% CI 1.61 to 4.42) in women with multiple factors combined. @@@ Conclusions This large community-based intervention trial to eradicate H. pylori is feasible and acceptable. The findings of this trial lead to a distinct evaluation of factors influencing eradication that should be generally considered for future eradication therapies.

• 出版日期2016-1
• 单位北京大学