Table 4.
Factors Associated with Failure of First-Line Helicobacter pylori Eradication*
| Variable | No. | Failure, No. (%) |
Univariable analysis | Multivariable analysis | |||
|---|---|---|---|---|---|---|---|
| OR (95% CI) | p-value | OR (95% CI) | p-value | ||||
| Regimen | |||||||
| Tegoprazan-based triple therapy | 316 | 54 (17.1) | 1.03 (0.67–1.57) | 0.904 | 1.03 (0.67–1.59) | 0.888 | |
| Rabeprazole-based triple therapy | 299 | 50 (16.7) | 1 | 1 | |||
| Adherence | |||||||
| Adherent | 611 | 101 (16.5) | 1 | 1 | |||
| Non-adherent | 4 | 3 (75.0) | 5.03 (1.01–25.28) | 0.050 | 4.05 (0.78–21.04) | 0.097 | |
| Age | |||||||
| <60 yr | 339 | 55 (16.2) | 1 | 1 | |||
| ≥60 yr | 276 | 49 (17.8) | 1.12 (0.73–1.70) | 0.615 | 0.98 (0.62–1.55) | 0.928 | |
| Sex | |||||||
| Male | 338 | 42 (12.4) | 1 | 1 | |||
| Female | 277 | 62 (22.4) | 2.03 (1.32–3.12) | 0.001 | 1.49 (0.84–2.64) | 0.169 | |
| Body mass index | |||||||
| <25 kg/m2 | 378 | 65 (17.2) | 1 | ||||
| ≥25 kg/m2 | 237 | 39 (16.5) | 0.95 (0.61–1.47) | 0.948 | |||
| Smoking habit | |||||||
| Never smoker | 358 | 75 (20.9) | 1 | 1 | |||
| Former smoker | 165 | 20 (12.1) | 0.52 (0.31–0.89) | 0.016 | 0.65 (0.33–1.27) | 0.206 | |
| Current smoker | 92 | 9 (9.8) | 0.41 (0.20–0.85) | 0.017 | 0.54 (0.23–1.25) | 0.147 | |
| Alcohol use | |||||||
| Absent | 309 | 61 (19.7) | 1 | 1 | |||
| <2/wk | 173 | 28 (16.2) | 0.79 (0.48–1.28) | 0.335 | 1.08 (0.63–1.85) | 0.778 | |
| ≥2/wk | 133 | 15 (11.3) | 0.52 (0.28–0.95) | 0.033 | 0.92 (0.45–1.86) | 0.816 | |
| Comorbidity | |||||||
| Hypertension | 155 | 32 (20.6) | 1.40 (0.88–2.23) | 0.153 | |||
| Cardiovascular disease | 17 | 5 (29.4) | 2.10 (0.72–6.09) | 0.172 | |||
| Diabetes | 57 | 15 (26.3) | 1.88 (1.00–3.54) | 0.050 | 2.03 (1.05–3.95) | 0.036 | |
| Cerebrovascular accident | 20 | 1 (5.0) | 0.25 (0.03–1.90) | 0.181 | |||
| Antithrombotic agent | 48 | 12 (25.0) | 1.72 (0.86–3.43) | 0.123 | |||
| Symptom | |||||||
| Reflux symptom† | 18 | 0 | NA | 0.998 | |||
| Nausea or vomiting | 9 | 1 (11.1) | 0.61 (0.08–4.93) | 0.643 | |||
| Gastric soreness | 53 | 8 (15.1) | 0.86 (0.39–1.90) | 0.712 | |||
| Abdominal discomfort | 68 | 15 (22.1) | 1.46 (0.79–2.70) | 0.232 | |||
| Abdominal pain | 16 | 2 (12.5) | 0.70 (0.16–3.11) | 0.635 | |||
| Others‡ | 11 | 2 (18.2) | 1.09 (0.23–5.14) | 0.910 | |||
| Indication for H. pylori eradication | |||||||
| Peptic ulcer | 92 | 16 (17.4) | 1.08 (0.60–1.94) | 0.809 | |||
| EGC treated with ESD | 6 | 3 (50.0) | 5.11 (1.01–25.74) | 0.048 | |||
| Gastric adenoma treated with ESD | 4 | 1 (25.0) | 1.70 (0.18–16.56) | 0.647 | |||
| H. pylori-associated gastritis | 513 | 84 (16.4) | 1 | ||||
| Nodular gastritis | 28 | 4 (14.3) | 0.81 (0.28–2.39) | 0.705 | |||
| Atrophic gastritis§ | |||||||
| Normal (C-0) | 110 | 17 (15.5) | 1 | ||||
| Mild (C-1, C-2) | 236 | 36 (15.3) | 0.99 (0.53–1.84) | 0.962 | |||
| Moderate (C-3, O-1) | 168 | 32 (19.0) | 1.29 (0.68–2.45) | 0.443 | |||
| Severe (O-2, O-3) | 101 | 19 (18.8) | 1.27 (0.62–2.60) | 0.518 | |||
OR, odds ratio; CI, confidence interval; EGC, early gastric cancer; ESD, endoscopic submucosal dissection; NA, not applicable.
*This analysis is performed on participants who received a follow-up test for H. pylori eradication; †Reflux symptoms include heartburn and acid regurgitation; ‡Other symptoms include anorexia, globus sensation, belching, and diarrhea; §Severity of atrophic gastritis is determined by Kimura-Takemoto classification.24