Evidence map›Paper›PMID 34862940›Full record

ReviewDigestive diseases and sciences2022

Pitfalls of Physician-Directed Treatment of Helicobacter pylori: Results from Two Phase 3 Clinical Trials and Real-World Prescribing Data.

Colin W Howden, Kely L Sheldon, June S Almenoff, William D Chey

2 registry-linked trialsOpen access · hybridAbstract readReview
In one paragraph

Review in Digestive diseases and sciences, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
1.5field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01980095 phase3completednot on this map

A Randomized Placebo-Controlled Phase 3 Study to Assess the Safety and Efficacy of RHB-105 in the Treatment of Confirmed Helicobacter Pylori (H. Pylori) Infection in Non-investigated Dyspepsia Patients

TypeinterventionalSponsorRedHill Biopharma LimitedRan2013 to 2015Enrolled119ConditionsDyspepsia, Helicobacter Pylori InfectionArmsRHB-105, Placebo
NCT03198507 phase3completednot on this map

A Randomized Double Blind Active Comparator Controlled Phase III Study to Assess the Safety and Efficacy of RHB-105 in the Treatment of Confirmed Helicobacter Pylori (H. Pylori) Infection

TypeinterventionalSponsorRedHill Biopharma LimitedRan2017 to 2018Enrolled455ConditionsHelicobacter Pylori Infection, DyspepsiaArmsRHB-105, Active Comparator
3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 10 citations in OpenAlex.

  1. Article
  2. Article
  3. Gastroenterology & hepatology · 2024
    Article
  4. Review
  5. Frontiers in pharmacology · 2024
    Article
  6. Clinical Implication of Drug Resistance forAntibiotics (Basel, Switzerland) · 2022
    Review
  7. Gastroenterology & hepatology · 2022
    Article
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 2 countries.

Colin W HowdenUniversity of Tennessee College of Medicine, Memphis, TN, USA.
Kely L SheldonRedHill Biopharma, 8045 Arco Corporate Drive, Suite 200, Raleigh, NC, 27617, USA. Ksheldon@redhillus.com.ORCID 0000-0002-0779-7580
June S AlmenoffRedHill Biopharma, 8045 Arco Corporate Drive, Suite 200, Raleigh, NC, 27617, USA.
William D CheyUniversity of Michigan, Ann Arbor, MI, USA.
East Surrey Hospital · GBUniversity of Michigan · USUniversity of Tennessee Health Science Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHelicobacter pylori (H. pylori) infects ~ 35% of Americans and can lead to serious sequelae if left untreated. Growing evidence indicates that clarithromycin-based therapies (CBT) are becoming increasingly ineffective for treating H. pylori infection. RHB-105 was approved by the US Food and Drug Administration in 2019 for the treatment of H. pylori infection in adults.

aimsThe primary aim of this study was to assess prescribing patterns and associated cure rates of physician-directed therapy for subjects with persistent H. pylori infection after participation in one of two Phase 3 clinical trials (ERADICATE Hp and ERADICATE Hp2).

methodsWe reviewed study reports to identify specific physician-directed regimens selected for subjects whose H. pylori infection was not eradicated. We also conducted a CYP2C19 genotype analysis of subjects who were prescribed CBT. Finally, we analyzed real-world H. pylori retail prescription data and compared these with to the physician-directed therapies in the clinical trials studies.

resultsFollowing ERADICATE Hp, CBT was prescribed for 27/31 (87%) subjects achieving a 59.3% cure rate. Following ERADICATE Hp2, CBT was prescribed for 48/94 (51%) subjects achieving a 60.4% cure rate. Rapid CYP2C19 metabolizers (2/11) had a cure rate of 18.2% with CBT. Real-world prescription data from IQVIA showed more than 80% of prescriptions for H. pylori infection were for CBT.

conclusionsRates of CBT use persist despite sub-optimal eradication rates. Since RHB-105 does not contain clarithromycin, it can be prescribed first-line without concerns about clarithromycin resistance or CYP2C19 status. NCT03198507 & NCT01980095.

Indexed as

Anti-Bacterial AgentsHelicobacter InfectionsHelicobacter pyloriPhysiciansAdultAmoxicillinClarithromycinClinical Trials, Phase III as TopicCytochrome P-450 CYP2C19Drug Therapy, CombinationGenotypeHumansProton Pump InhibitorsAmoxicillinAnti-Bacterial AgentsClarithromycinCytochrome P-450 CYP2C19Proton Pump InhibitorsClarithromycinCYP2C19Helicobacter pyloriRHB-105RifabutinStomachTalicia

Identifiers

PMID34862940
PMCPMC9352601
OpenAlexW3215104527

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.