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[A multi-center, randomized controlled study on the effect of Saccharomyces boulardii combined with triple therapy for the initial eradication of Helicobacter pylori infection].

Abstract
Objective: To assess the efficacy and safety of Saccharomyces boulardii (S. boulardii) in combination with triple therapy as a first-line regimen for the eradication of Helicobacter pylori (H. pylori) in non-ulcer dyspepsia (NUD) patients. Methods: A total of 497 Helicobacter pylori-positive patients who underwent gastroscopy and diagnosed with NUD were enrolled from June 2018 to January 2020 in 9 medical centers across China. Participants were segmentedly randomly divided into 3 groups. Patients in group A received S. boulardii for 14 days and triple therapy for 10 days, while patients in group B received bismuth quadruple group for 10 days, and patients in group C received triple therapy for 10 days. The H. pylori status was determined by the 13C-urea breath test on the 44th day of the treatment. Symptom improvement and adverse reactions were assessed on the 14th and 44th day. Results: There were 229 males and 268 females in all 497 patients enrolled. They were aged 18-69 (46.1±11.8) years and 472 of them (158 cases in group A, 159 cases in group B, and 155 cases in group C) completed the trial. The intention-to-treat (ITT) eradication rates in patients in patients A, B and C were 77.8% (126/162), 80.1% (137/171) and 65.2% (107/164) respectively, and per protocol-based (PP) eradication rates were 79.7% (126/158), 86.2% (137/159) and 69.0% (107/155) respectively. The differences were statistically significant in ITT and PP analysis among 3 groups (ITT: χ²=11.14, P<0.01; PP: χ²=13.86, P<0.01). There was no significant difference between eradication rates of two quadruple therapys(all P>0.05), but both of them were significantly higher than that of standard triple therapy (both P<0.05). Statistics revealed that both quadruple therapys led to significantly higher symptom improvement of belching compared with that of standard triple therapy in day 14 (P<0.05). The relief of abdominal distension and belching symptom scores of group A were significantly higher than those of group C in day 44(all P<0.05). There was no serious adverse event reported. The incidence of diarrhea in group A was significantly lower than those in the other two groups (both P<0.05). Conclusions: The combination of S. boulardii and triple therapy can achieve a better eradication effect on H. pylori infection with NUD, and has advantages in symptom relief and safety.
AuthorsG B Yang, F L Hu, W Cheng, J Q Gao, Z Y Sheng, Y J Zhang, X L Du, Y Zuo, Y Li, B M Chen, Z H Wang, Zihan Zhao
JournalZhonghua yi xue za zhi (Zhonghua Yi Xue Za Zhi) Vol. 102 Issue 18 Pg. 1383-1388 (May 17 2022) ISSN: 0376-2491 [Print] China
PMID35545584 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial)
Chemical References
  • Anti-Bacterial Agents
  • Amoxicillin
  • Bismuth
Topics
  • Amoxicillin (therapeutic use)
  • Anti-Bacterial Agents (therapeutic use)
  • Bismuth (therapeutic use)
  • Drug Therapy, Combination
  • Eructation (drug therapy)
  • Female
  • Gastritis (drug therapy)
  • Helicobacter Infections (drug therapy)
  • Helicobacter pylori
  • Humans
  • Male
  • Saccharomyces boulardii
  • Treatment Outcome

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