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Effect of pantoprazole and Helicobacter pylori therapy on uninvestigated dyspeptic patients.

AbstractBACKGROUND/AIMS:
This study aimed to test the efficacy of empirical proton pump inhibitor use and Helicobacter pylori therapy for uninvestigated dyspepsia in a population with a high prevalence of H. pylori.
MATERIAL AND METHODS:
The study had a two-stage design. In the first stage, the efficacy of 4-week pantoprazole treatment was compared with placebo in patients with uninvestigated dyspepsia. In the second stage, the efficacies of 2-week treatment with pantoprazole in H. pylori-negative patients and H. pylori eradication therapy (pantoprazole + amoxicillin + clarithromycin) in H. pylori-positive patients were compared. The primary endpoint was sufficient overall symptom relief (Global Overall Symptom score ≤2; no or minimal symptoms) at the end of treatment.
RESULTS:
In the first stage, sufficient overall symptom relief was achieved by 25.2% of patients in the pantoprazole group and 15.5% of patients in the placebo group, a difference that was not statistically significant (p=0.06). In the second stage, the rate of sufficient overall symptom relief was higher in the H. pylori therapy group than in the pantoprazole group (37.1% vs. 23.4%; p=0.02). After untreated follow-up, sufficient overall symptom relief remained significantly higher in the H. pylori therapy group than in the pantoprazole group (39.7% vs. 18%; p<0.001). Almost all patients receiving pantoprazole experienced symptom relapse after treatment.
CONCLUSIONS:
This study validated the use of a test-and-treat strategy against H. pylori in uninvestigated dyspepsia, which may be an advisable treatment approach for uninvestigated dyspeptic patients in countries with a high prevalence of H. pylori.
AuthorsBirol Baysal, Hakan Şentürk, Omar Masri, Mukaddes Tozlu, Yusuf Kayar, Elif Arabacı, Ömer Uysal, Mehmet Sait Buğdacı, Ali Tüzün İnce
JournalThe Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology (Turk J Gastroenterol) Vol. 26 Issue 1 Pg. 6-14 (Jan 2015) ISSN: 2148-5607 [Electronic] Turkey
PMID25698264 (Publication Type: Comparative Study, Journal Article)
Chemical References
  • 2-Pyridinylmethylsulfinylbenzimidazoles
  • Anti-Bacterial Agents
  • Anti-Ulcer Agents
  • Amoxicillin
  • Pantoprazole
  • Clarithromycin
Topics
  • 2-Pyridinylmethylsulfinylbenzimidazoles (therapeutic use)
  • Adult
  • Amoxicillin (therapeutic use)
  • Anti-Bacterial Agents (therapeutic use)
  • Anti-Ulcer Agents (therapeutic use)
  • Clarithromycin (therapeutic use)
  • Drug Therapy, Combination (methods)
  • Dyspepsia (drug therapy, microbiology)
  • Female
  • Helicobacter pylori (drug effects)
  • Humans
  • Male
  • Middle Aged
  • Pantoprazole
  • Recurrence
  • Treatment Outcome
  • Young Adult

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