Novel triple therapy eradicates Helicobacter pylori

A new three-drug combination therapy for the treatment of Helicobacter pylori infection is currently in phase 3 clinical trials. The combination RHB-105, consisting of amoxicillin (3 g), omeprazole (120 mg), and rifabutin (150 mg) in a single-dose capsule, achieved high eradication rates of H. pylori infection. [Ann Intern Med 2020;172(12):795–802]

The trial, named ERADICATE Hp2, involved 455 treatment-naïve adults with stomach discomfort and confirmed H. pylori infection. The participants were recruited from 55 sites across the US. Participants were randomized to receive either RHB-105 or amoxicillin (3 g) plus omeprazole (120 mg) for 14 days.

It was found that 4 weeks after the treatment ended, H. pylori was eradicated in 83.8% of patients who received the RHB-105 triple therapy compared with 57.7% in the omeprazole and amoxicillin group (p<0.001). The microbe’s resistance to clarithromycin or metronidazole did not affect eradication rates, and rifabutin resistance was not detected.

The study finding indicate that RHB-105 is a potential first-line therapy in the treatment of H. pylori infection. The finding is important in light of increasing antibiotic resistance, which has substantially reduced the eradication rates of current existing therapies.