Three-day lansoprazole quadruple therapy for Helicobacter pylori-positive duodenal ulcers: a randomized controlled study.

Abstract

AIM:

To compare the efficacy and tolerability of a 3-day quadruple therapy with a standard 7-day triple therapy in eradicating Helicobacter pylori infection and healing duodenal ulcers.

METHODS:

Patients with H. pylori-positive duodenal ulcers were randomized to receive either lansoprazole 30 mg, clarithromycin 500 mg, and metronidazole 400 mg twice daily for 7 days (LCM-7) or lansoprazole 30 mg, clarithromycin 500 mg, metronidazole 400 mg, and bismuth subcitrate 240 mg twice daily for 3 days (LCMB-3). No pre- or post-treatment acid suppression was used. Follow-up endoscopy was performed at week 6.

RESULTS:

A total of 118 patients were recruited. Sixty patients in the LCM-7 group and 53 patients in the LCMB-3 group returned for endoscopy. Intention-to-treat eradication rates were 87% and 86% (P=0.94) and per protocol eradication rates were 87% and 94% (P=0.29) in the LCM-7 and LCMB-3 groups, respectively. Per protocol and intention-to-treat ulcer healing rates were 98% and 98% in LCM-7 and 100% and 91% in LCMB-3, respectively. There were no significant differences in efficacy in relation to the initial metronidazole and clarithromycin susceptibility. Significant reduction in the duration of side-effects was found in the LCMB-3 group.

CONCLUSION:

The 3-day quadruple therapy is highly effective, better tolerated and can be considered as a first-line therapy in duodenal ulcer management.

• Authors: B C Wong, W H Wang, W M Wong, G K Lau, F M Fung, N N Kung, K M Chu, K C Lai, W H Hu, F L Hu, X G Liu, C K Chan, M F Yuen, W M Hui, S K Lam
• Journal: Alimentary pharmacology & therapeutics (Aliment Pharmacol Ther) Vol. 15 Issue 6 Pg. 843-9 (Jun 2001) ISSN: 0269-2813 [Print] England
• PMID: 11380322 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• 2-Pyridinylmethylsulfinylbenzimidazoles
• Antacids
• Anti-Bacterial Agents
• Anti-Infective Agents
• Organometallic Compounds
• Lansoprazole
• Metronidazole
• Clarithromycin
• bismuth tripotassium dicitrate
• Omeprazole

Topics

• 2-Pyridinylmethylsulfinylbenzimidazoles
• Administration, Oral
• Adolescent
• Adult
• Aged
• Antacids (administration & dosage, therapeutic use)
• Anti-Bacterial Agents (administration & dosage, therapeutic use)
• Anti-Infective Agents (administration & dosage, adverse effects, pharmacology)
• Clarithromycin (administration & dosage, therapeutic use)
• Drug Administration Schedule
• Drug Therapy, Combination
• Duodenal Ulcer (drug therapy, microbiology, pathology)
• Female
• Humans
• Lansoprazole
• Male
• Metronidazole (administration & dosage, therapeutic use)
• Middle Aged
• Omeprazole (administration & dosage, adverse effects, analogs & derivatives, pharmacology)
• Organometallic Compounds (therapeutic use)
• Treatment Outcome