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The following is a summary of “Efficacy and safety of standard triple therapy for helicobacter pylori eradication in Latin America,” published in the September 2024 issue of Gastroenterology by Diaz-Rodriguez et al.

Helicobacter pylori infection affects over 50% of Latin Americans, causing damage to the stomach lining. There is limited data on the best treatments for this, particularly in the region. 

Researchers conducted a retrospective study evaluating the effectiveness and safety of standard triple therapy (STT) in Latin America.

They analyzed Randomized Controlled Trials published until 2020, comparing STT to other treatments. Cumulative relative risks (RR) with 95% CIs were estimated using both intention-to-treat (ITT) and per-protocol (PP) analysis. 

The results showed that 11 clinical trials (1995-2013) showed cumulative eradication rates of 78.31-90.63% (ITT) and 76.71 -93.55% (PP). The STT outperformed sequential therapy (ITT-RR: 10.6, 95% CI: 1.01-1.12) (PP-RR: 10.6, 95% CI: 1.02-1.11) and dual therapy (ITT-RR: 1.61, 95% CI: 1.13-2.30) (PP—RR: 1.72, 95% CI: 1.25-2.37), but was less effective than other triple therapies (PP—RR: 0.85, 95% CI: 0.78-092). Diarrhea, metallic taste, nausea, vomiting, and headache were the most common symptoms across treatments. Abdominal pain was associated with STT (ITT—RR: 1.75, 95% CI: 1.07-2.86).

Investigators concluded that STT is safe but has limited efficacy (eradication rates mostly below 90%). Due to increasing clarithromycin resistance, it is not recommended as a first-line treatment. The study also highlights limited data from some Latin American countries.

Source: journals.lww.com/jcge/abstract/9900/efficacy_and_safety_of_standard_triple_therapy_for.342.aspx