Editorial: Will H. Pylori Stagger Under the Weight of This LOAD? A Novel But Expensive Eradication Regimen

• Published in: The American journal of gastroenterology Vol. 106; no. 11; p. 1976
• Main Authors: Watson, James B, Moss, Steven F
• Format: Journal Article
• Language: English
• Published: New York Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins 01.11.2011
• Subjects: Gastroenterology
• ISSN: 0002-9270; 1572-0241
• DOI: 10.1038/ajg.2011.309

In the era of increasing Helicobacter pylori resistance to clarithromycin and metronidazole used in standard treatments, newer well-tolerated regimens with high eradication success rates in practice are urgently needed. In this edition of the American Journal of Gastroenterology, a clinical trial of a novel drug combination is presented, demonstrating significantly more success in comparison with a standard "triple therapy." The new regimen (referred to as LOAD) comprises three antibiotics, levofloxaxin, doxycycline, and nitazoxanide, together with omeprazole. The LOAD regimen had around a 90% eradication rate compared with only 73% with a standard "triple therapy" regimen of amoxicillin, clarithromycin, and lansoprazole. The use of this relatively expensive novel drug combination would represent an absolute increased eradication rate of 17%, with a number needed to treat to achieve one more successful eradication of 5.88. Results from this preliminary study should prompt further evaluation of LOAD in rigorously designed clinical studies.