RT Journal Article SR Electronic T1 Sequential therapy for 10 days versus triple therapy for 14 days in the eradication of Helicobacter pylori in the community and hospital populations: a randomised trial JF Gut JO Gut FD BMJ Publishing Group Ltd and British Society of Gastroenterology SP 1784 OP 1792 DO 10.1136/gutjnl-2015-310142 VO 65 IS 11 A1 Jyh-Ming Liou A1 Chieh-Chang Chen A1 Chi-Yang Chang A1 Mei-Jyh Chen A1 Chien-Chuan Chen A1 Yu-Jen Fang A1 Ji-Yuh Lee A1 Tsung-Hua Yang A1 Jiing-Chyuan Luo A1 Jeng-Yih Wu A1 Tai-Cherng Liou A1 Wen-Hsiung Chang A1 Yao-Chun Hsu A1 Cheng-Hao Tseng A1 Chun-Chao Chang A1 Ming-Jong Bair A1 Tzeng-Ying Liu A1 Chun-Fu Hsieh A1 Feng-Yun Tsao A1 Chia-Tung Shun A1 Jaw-Town Lin A1 Yi-Chia Lee A1 Ming-Shiang Wu YR 2016 UL http://gut.bmj.com/content/65/11/1784.abstract AB Objective Significant heterogeneity was observed in previous trials that assessed the efficacies of sequential therapy for 10 days (S10) versus triple therapy for 14 days (T14) in the first-line treatment of Helicobacter pylori. We aimed to compare the efficacy of S10 and T14 and assess the factors affecting their efficacies.Design We conducted this open-label randomised multicentre trial in eight hospitals and one community in Taiwan. 1300 adult subjects with H pylori infection naïve to treatment were randomised (1:1) to receive S10 (lansoprazole and amoxicillin for the first 5 days, followed by lansoprazole, clarithromycin and metronidazole for another 5 days) or T14 (lansoprazole, amoxicillin and clarithromycin for 14 days). All drugs were given twice daily. Successful eradication was defined as negative 13C-urea breath test at least 6 weeks after treatment. Our primary outcome was the eradication rate by intention-to-treat (ITT) and per-protocol (PP) analyses. Antibiotic resistance was determined by agar dilution test.Results The eradication rates of S10 and T14 were 87.2% (567/650, 95% CI 84.4% to 89.6%) and 85.7% (557/650, 95% CI 82.8% to 88.2%) in the ITT analysis, respectively, and were 91.6% (556/607, 95% CI 89.1% to 93.4%) and 91.0% (548/602, 95% CI 88.5% to 93.1%) in the PP analysis, respectively. There were no differences in compliance or adverse effects. The eradication rates in strains susceptible and resistant to clarithromycin were 90.7% and 62.2%, respectively, for S10, and were 91.5% and 44.4%, respectively, for T14. The efficacy of T14, but not S10, was affected by CYP2C19 polymorphism.Conclusions S10 was not superior to T14 in areas with low clarithromycin resistance.Trial registration number NCT01607918.