Ethical Considerations of Comparing Sequential and Traditional Anti–<i>Helicobacter pylori</i> Therapy
Authors: Dino Vaira, Angelo Zullo, Nimish Vakil
Journal: Annals of Internal Medicine (2007)

Letters18 September 2007Ethical Considerations of Comparing Sequential and Traditional Anti–Helicobacter pylori TherapyDino Vaira, MD, Angelo Zullo, MD, and Nimish Vakil, MDDino Vaira, MDFrom University of Bologna, 40138 Bologna, Italy; Nuovo Regina Margherita Hospital, 00153 Rome, Italy; and University of Wisconsin School of Medicine and Public Health, Madison, WI 53705.Search for more papers by this author, Angelo Zullo, MDFrom University of Bologna, 40138 Bologna, Italy; Nuovo Regina Margherita Hospital, 00153 Rome, Italy; and University of Wisconsin School of Medicine and Public Health, Madison, WI 53705.Search for more papers by this author, and Nimish Vakil, MDFrom University of Bologna, 40138 Bologna, Italy; Nuovo Regina Margherita Hospital, 00153 Rome, Italy; and University of Wisconsin School of Medicine and Public Health, Madison, WI 53705.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-147-6-200709180-00023 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:There are several misstatements in Drs. Graham and Yamaoka's letter. There was no sponsor for our study, and triple therapy is a legacy therapy solely in a fantasy world. Triple therapy was recently reaffirmed by an international consensus group as the principal therapy to be used worldwide and by U.S. and Japanese guidelines (1–3). It is, therefore, an appropriate control group for any new therapy. Our study began in 2003, when it was uncertain whether sequential therapy was truly effective in large cohorts. A fundamental question remained unanswered until now: Was sequential therapy the answer to clarithromycin resistance? ...References1. Malfertheiner P, Megraud F, O'Morain C, Bazzoli F, El-Omar E, Graham D, et al. Current concepts in the management of Helicobacter pylori infection: the Maastricht III Consensus Report. Gut. 2007;56:772-81. [PMID: 17170018] CrossrefMedlineGoogle Scholar2. Fujioka T, Yoshiiwa A, Okimoto T, Kodama M, Murakami K. Guidelines for the management of Helicobacter pylori infection in Japan: current status and future prospects. J Gastroenterol. 2007;42 Suppl 17 3-6. [PMID: 17238017] CrossrefMedlineGoogle Scholar3. Chey WD, Wong BC. American College of Gastroenterology Guideline on the Management of Helicobacter pylori Infection. Am J Gastroenterol. 2007;:. [PMID: 17608775] CrossrefMedlineGoogle Scholar4. Gatta L, Zullo A, Perna F, Ricci C, De Francesco V, Tampieri A, et al. A 10-day levofloxacin-based triple therapy in patients who have failed two eradication courses. Aliment Pharmacol Ther. 2005;22:45-9. [PMID: 15963079] CrossrefMedlineGoogle Scholar5. Grant A. Stopping clinical trials early [Editorial]. BMJ. 2004;329:525-6. [PMID: 15345605] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Dino Vaira, MD; Angelo Zullo, MD; Nimish Vakil, MDAffiliations: From University of Bologna, 40138 Bologna, Italy; Nuovo Regina Margherita Hospital, 00153 Rome, Italy; and University of Wisconsin School of Medicine and Public Health, Madison, WI 53705.Disclosures: Consultancies: N. Vakil (Altana Pharma [now Nicomed]). Stock ownership or options (other than mutual funds): D. Vaira (Meridian Bioscience). Grants received: N. Vakil (Altana Pharma [now Nicomed]). PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoSequential Therapy versus Standard Triple-Drug Therapy for Helicobacter pylori Eradication Dino Vaira , Angelo Zullo , Nimish Vakil , Luigi Gatta , Chiara Ricci , Federico Perna , Cesare Hassan , Veronica Bernabucci , Andrea Tampieri , and Sergio Morini Ethical Considerations of Comparing Sequential and Traditional Anti–Helicobacter pylori Therapy David Y. Graham and Yoshio Yamaoka Metrics 18 September 2007Volume 147, Issue 6Page: 435-436KeywordsAdverse reactionsCohort studiesConflicts of interestSafetySafety studiesSalvage antiretroviral therapy ePublished: 18 September 2007 Issue Published: 18 September 2007 Copyright & PermissionsCopyright © 2007 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...