The OAC and OMC options.

Abstract

OBJECTIVE:

In three studies, the two most successful regimens in the MACH1 study (omeprazole-amoxycillin-clarithromycin (OAC) and omeprazole-metronidazole-clarithromycin (OMC)) were investigated further.

DESIGN:

Double-blind, randomized, international, multi-centre studies with parallel groups.

SETTING:

The studies were performed at centres in France, Germany, Ireland, Norway, Sweden and the UK (MACH2), Canada (DU-MACH) and Germany, Hungary and Poland (GU-MACH).

PARTICIPANTS AND INTERVENTIONS:

In MACH2, the influence of omeprazole on eradication was investigated in patients with duodenal ulcers in remission, using OAC, AC, OMC and MC. In DU-MACH and GU-MACH, eradication and relapse rates were investigated in patients with active peptic ulcers, using: OAC, OMC and omeprazole alone.

MAIN OUTCOME MEASURES:

Eradication of Helicobacter pylori. In patients with active peptic ulcer, ulcer healing was also assessed.

RESULTS:

In MACH2 (n = 514, intention-to-treat (ITT) analysis), the addition of omeprazole to AC increased the eradication rate from 26 to 94%. The corresponding increase for MC/ OMC was from 69 to 87%. The efficacy of the AC and OAC regimens was unaffected by primary metronidazole resistance, while that of MC was halved and that of OMC reduced by 15%. Clarithromycin resistance was uncommon. In DU-MACH and GU-MACH (n = 146 and 145, ITT analysis), eradication rates were high with both regimens. Ulcer healing rates were also high in all treatment groups; ulcer relapse was significantly less frequent in the OAC and OMC groups. All regimens were well tolerated.

CONCLUSION:

Omeprazole triple therapy is highly effective in patients with active or healed peptic ulcer disease, and is well tolerated.

• Authors: P Unge
• Journal: European journal of gastroenterology & hepatology (Eur J Gastroenterol Hepatol) Vol. 11 Suppl 2 Pg. S9-17; discussion S23-4 (Aug 1999) ISSN: 0954-691X [Print] England
• PMID: 10503817 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)

Chemical References

• Anti-Bacterial Agents
• Anti-Ulcer Agents
• Metronidazole
• Amoxicillin
• Clarithromycin
• Omeprazole

Topics

• Amoxicillin (therapeutic use)
• Anti-Bacterial Agents (therapeutic use)
• Anti-Ulcer Agents (therapeutic use)
• Clarithromycin (therapeutic use)
• Double-Blind Method
• Drug Resistance, Microbial
• Drug Therapy, Combination
• Helicobacter Infections (drug therapy)
• Helicobacter pylori
• Humans
• Metronidazole (therapeutic use)
• Multicenter Studies as Topic
• Omeprazole (therapeutic use)
• Randomized Controlled Trials as Topic
• Treatment Outcome