Treating Helicobacter pylori Infection with Rifasutenizol
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Reviewed & Translated by Dat Tien Nguyen, B.A, ScM.
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Posted on April 13th, 2026
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Helicobacter pylori infection is the most common cause of chronic gastritis that can result in ulceration and gastric cancer. Current treatment regimen composed of antibiotics and acid-suppressing agents. However, due to the increased frequency of antimicrobial resistance, new treatment options are urgently needed. A study, recently published in the Lancet, had explored the usage of rifasutenizol to treat Helicobacter pylori infection.
Funding Source(s): TenNor Therapeutics
The phase 3 clinical study was conducted in China, and it included 700 participants who had been diagnosed with Helicobacter pylori infection using a positive C-13 urea breath test. Gastric biopsy and histological examination were then utilized to confirm the status of the infection. This endoscopic examination found that around 4% of the patients were affected with peptic ulceration. From the biopsy sample, the antimicrobial susceptibility profile of the bacteria was examined, and metronidazole resistance was the most common at around 70% of the samples. Clarithromycin and levofloxacin resistance are a bit less frequent at around 40% and 35, respectively. Resistance to amoxicillin is uncommon at 8%, and none of the samples were resistant to rifasutenizol.
The participants were randomly assigned to be treated with either the standard therapy or the experimental therapy. The standard regimen included 2 antibiotics (500 mg of clarithromycin and 1 g of amoxicillin), a proton-pump inhibitor (20 mg of rabeprazole) and bismuth potassium citrate to provide additional protection against gastric acid. The experimental regimen also has 1 g of amoxicillin, 20 mg of rabeprazole, but it also has 400 mg of rifasutenizol. Rifasutenizol is formed by the conjugation of rifamycin and nitroimidazole.
After 14 days of treatment, the researchers found that Helicobacter pylori was eradicated in 92% of patients treated with the regimen with rifasutenizol, which is statistically similar to the 87.9% eradication rate observed in the group treated with the standard regimen. The author noted that despite the high resistance rate against metronidazole, which is a structural relative to nitroimidazole, the effectiveness of the rifasutenizol is not affected. The author stressed the importance of antibiotic stewardship, as overuse can deem rifasutenizol ineffective. More importantly, there is a concern that unnecessary use of rifasutenizol can induce resistance against rifamycin-related agents such as rifampin, which is an essential antibiotic for tuberculosis.
Funding Source(s): TenNor Therapeutics
The phase 3 clinical study was conducted in China, and it included 700 participants who had been diagnosed with Helicobacter pylori infection using a positive C-13 urea breath test. Gastric biopsy and histological examination were then utilized to confirm the status of the infection. This endoscopic examination found that around 4% of the patients were affected with peptic ulceration. From the biopsy sample, the antimicrobial susceptibility profile of the bacteria was examined, and metronidazole resistance was the most common at around 70% of the samples. Clarithromycin and levofloxacin resistance are a bit less frequent at around 40% and 35, respectively. Resistance to amoxicillin is uncommon at 8%, and none of the samples were resistant to rifasutenizol.
The participants were randomly assigned to be treated with either the standard therapy or the experimental therapy. The standard regimen included 2 antibiotics (500 mg of clarithromycin and 1 g of amoxicillin), a proton-pump inhibitor (20 mg of rabeprazole) and bismuth potassium citrate to provide additional protection against gastric acid. The experimental regimen also has 1 g of amoxicillin, 20 mg of rabeprazole, but it also has 400 mg of rifasutenizol. Rifasutenizol is formed by the conjugation of rifamycin and nitroimidazole.
After 14 days of treatment, the researchers found that Helicobacter pylori was eradicated in 92% of patients treated with the regimen with rifasutenizol, which is statistically similar to the 87.9% eradication rate observed in the group treated with the standard regimen. The author noted that despite the high resistance rate against metronidazole, which is a structural relative to nitroimidazole, the effectiveness of the rifasutenizol is not affected. The author stressed the importance of antibiotic stewardship, as overuse can deem rifasutenizol ineffective. More importantly, there is a concern that unnecessary use of rifasutenizol can induce resistance against rifamycin-related agents such as rifampin, which is an essential antibiotic for tuberculosis.