Comparable Helicobacter pylori eradication rates obtained with 4- and 7-day rabeprazole-based triple therapy: a preliminary study.

Abstract

BACKGROUND:

Rabeprazole is a new proton pump inhibitor, which has been reported to induce a faster acid suppression than other drugs of the same category. This might be useful to reduce the duration of anti-Helicobacter therapies.

AIMS:

The aim of this study was to assess whether there is the possibility of shortening a rabeprazole-based triple therapy from 7 to 4 days without compromising its efficacy in the eradication of Helicobacter pylori infection.

PATIENTS:

A total of 128 consecutive dyspeptic patients with H. pylori infection were recruited for this controlled, randomized, open and parallel-group trial comparing the efficacy of two durations of the same rabeprazole-based triple therapy.

METHODS:

All patients were subdivided to receive a combination of rabeprazole 20 mg twice daily, clarithromycin 250 mg twice daily and metronidazole 500 mg twice daily (RCM) for 4 days (n = 63) and for 7 days (n = 65). At baseline, they underwent breath 13C-urea test and endoscopy with biopsies for rapid urease testing and histology to confirm infection with H. pylori. Eradication was determined by a negative 13C-urea breath test within 28-32 days after the end of therapy.

RESULTS:

Overall eradication rates were similar for patients treated with the 4- and the 7-day periods (intention-to-treat and per-protocol analyses showed a success rate of 81% versus 78% and 88% versus 85%, respectively; P = NS). Tolerance was similar in both groups. Most adverse events were mild to moderate, and only two patients were withdrawn because of them.

CONCLUSIONS:

The eradication rate of the 4-day regimen was equivalent to that of the same 7-day regimen based on rabeprazole plus clarithromycin and metronidazole. Therefore, the 4-day regimen of RCM seems to give us the possibility of adopting a shorter-than-usual duration of therapy against H. pylori.

• Authors: C Gambaro, C Bilardi, P Dulbecco, E Iiritano, P Zentilin, C Mansia, P Usai, S Vigneri, V Savarino
• Journal: Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver (Dig Liver Dis) Vol. 35 Issue 11 Pg. 763-7 (Nov 2003) ISSN: 1590-8658 [Print] Netherlands
• PMID: 14674665 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)

Chemical References

• 2-Pyridinylmethylsulfinylbenzimidazoles
• Anti-Bacterial Agents
• Anti-Infective Agents
• Anti-Ulcer Agents
• Benzimidazoles
• Proton Pump Inhibitors
• Metronidazole
• Rabeprazole
• Clarithromycin
• Omeprazole

Topics

• 2-Pyridinylmethylsulfinylbenzimidazoles
• Anti-Bacterial Agents (administration & dosage, adverse effects)
• Anti-Infective Agents (administration & dosage, adverse effects)
• Anti-Ulcer Agents (administration & dosage, adverse effects)
• Benzimidazoles (administration & dosage, adverse effects)
• Clarithromycin (administration & dosage, adverse effects)
• Drug Administration Schedule
• Drug Therapy, Combination
• Dyspepsia (microbiology)
• Female
• Helicobacter Infections (drug therapy)
• Helicobacter pylori (drug effects)
• Humans
• Male
• Metronidazole (administration & dosage, adverse effects)
• Middle Aged
• Omeprazole (analogs & derivatives)
• Peptic Ulcer (drug therapy, microbiology)
• Pilot Projects
• Prospective Studies
• Proton Pump Inhibitors
• Rabeprazole
• Treatment Outcome