Abstract | BACKGROUND/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.
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Authors | Birol Baysal, Hakan Şentürk, Omar Masri, Mukaddes Tozlu, Yusuf Kayar, Elif Arabacı, Ömer Uysal, Mehmet Sait Buğdacı, Ali Tüzün İnce |
Journal | The 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 |
PMID | 25698264
(Publication Type: Comparative Study, Journal Article)
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Chemical References |
- 2-Pyridinylmethylsulfinylbenzimidazoles
- Anti-Bacterial Agents
- Anti-Ulcer Agents
- Amoxicillin
- Pantoprazole
- Clarithromycin
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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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