Efficacy and safety of H. pylori regimens containing rifabutin

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Created On: 07/05/2022

This study was carried out to investigate safety and effectiveness of rifabutin-containing regimens for Helicobacter pylori (H. pylori) eradication.

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Key take away

Rifabutin-containing therapy depicts a safe and efficacious approach following one or even more failures of H. pylori elimination treatment.

Background

This study was carried out to investigate safety and effectiveness of rifabutin-containing regimens for Helicobacter pylori (H. pylori) eradication.

Method

In this sub-analysis of European Registry on H. pylori Management (Hp-EuReg), rifabutin-treated people were registered. Per-protocol and modified intention-to-treat evaluations were conducted. The study data were subjected to quality control. H. pylori eradication rate achieved was the major outcome ascertained.

Result

In total, 500 volunteers (mean age 52 years, 4% with peptic ulcer, and 63% with dyspepsia) incorporated in Hp-EuReg received rifabutin therapy. In 63% of cases, the culture was conducted. Triple resistance (to levofloxacin, metronidazole, clarithromycin,) was witnessed in 39% of cases, and dual resistance (to both metronidazole and clarithromycin) was witnessed in 46% of cases.

Rifabutin was utilized as a part of triple therapy along with proton-pump-inhibitor and amoxicillin in about 87% of cases. The addition of bismuth to the triple regimen was done in an additional 6% of participants. Rifabutin therapy was majorly utilized in fourth-line (27%), third-line (25%), and second-line (32%) regimens, attaining 66%, 80%, and 78% overall efficacy by modified intention-to-treat, respectively.

The compliance with treatment was found to be 89%. In 26% of the participants (most commonly nausea), at least 1 adverse effect was noted. Notably, 1 severe adverse effect (0.2%) was witnessed in 1 subject with leukopenia and thrombocytopenia with fever needing hospitalization.