4-day triple therapy with rabeprazole, amoxicillin and clarithromycin in the eradication of Helicobacter pylori in patients with peptic ulcer disease - - A pilot study - -

Lüth, Stefan; Teyssen, Stephan; Kölbel, C. B. M.; Singer, Mirko

doi:10.1055/s-2001-12873

Cited by 19 publications

(7 citation statements)

References 14 publications

(17 reference statements)

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“…Small studies in non‐US populations describe 1‐, 2‐, 3‐, 4‐ and 5‐day treatment strategies. However, the results are variable, and many of the studies are small and therefore likely to exaggerate the success of the regimen 3–12 . Some studies have suggested that short treatment regimens may be effective in patients with ulcer disease, but that eradication percentages may be poorer in patients with H. pylori infection without ulcer disease and that these patients may require longer courses of therapy 13, 14 .…”

Section: Introductionmentioning

confidence: 99%

Seven‐day therapy for Helicobacter pylori in the United States

Vakil¹,

Lanza

Schwartz³

et al. 2004

Aliment Pharmacol Ther

152

107

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Section: Introductionmentioning

confidence: 99%

Seven‐day therapy for Helicobacter pylori in the United States

Vakil¹,

Lanza

Schwartz³

et al. 2004

Aliment Pharmacol Ther

152

107

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“…2 In addition, rabeprazole was shown to have a more rapid onset of action and greater antisecretory activity than those of omeprazole and other PPIs in the inhibition of acid secretion. 8,9 One group of authors 10 showed that 4-day triple therapy with rabeprazole, amoxicillin, and clarithromycin achieved an eradication rate of 90%, comparable to that of a 7-day triple therapy regimen.…”

mentioning

confidence: 99%

Time‐Dependent Amplified Pharmacokinetic and Pharmacodynamic Responses of Rabeprazole in Cytochrome P450 2C19 Poor Metabolizers

et al. 2003

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“…Short‐term triple therapy is not regularly used for H. pylori treatment because of the inconsistency in the reported eradiation rates; however, this may be partly due to the failure to report the CYP2C19 genotypes of the subjects [5–7, 34–36]. The successful H. pylori eradication in CYP2C19 PMs seen in the present study suggests the possible use of short‐term triple therapy in such patients.…”

Section: Discussionmentioning

confidence: 65%

“…Nonetheless, short‐term (i.e. <7 days) triple therapy has been reported to increase patient compliance and reduce costs and adverse effects [5–7], but the evidence is limited and the rationale needs to be elucidated.…”

Section: Introductionmentioning

confidence: 99%

Pharmacokinetic– pharmacodynamic analysis of the role of CYP2C19 genotypes in short‐term rabeprazole‐based triple therapy against Helicobacter pylori

Yang

Uang

et al. 2009

Brit J Clinical Pharma

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WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT• Asians have a higher percentage of CYP2C19 poor metabolizers (PMs) and a high percentage of Helicobacter pylori infection compared with Whites.• Although rabeprazole has been suggested to be least affected by CYP2C19 genotype, the pharmacokinetic properties of rabeprazole have been shown to correlate with the CYP2C19 genotype. • Short-term (i.e. <7 days) rabeprazole-based triple therapy has been suggested for its use in eradicating H. pylori, whereas the eradication rate has been reported variously as 90-27% without CYP2C19 genotyping. WHAT THIS STUDY ADDS• Population pharmacokinetic-pharmacodynamic analysis showed that the plasma rabeprazole levels, the values of keo (the first-order rate constant for drug dissipation from the effect compartment), and the predicted gastrin-time profile were higher in CYP2C19 PMs than in extensive metabolizers (EMs) after multiple dosing.• Helicobacter pylori was eradicated in all CYP2C19 PMs except in one patient infected by a resistant strain, whereas the eradication rates ranged from 58 to 85% in CYP2C19 EMs. AIMSThe aim was to explore the role of CYP2C19 polymorphism in short-term rabeprazole-based triple therapy against Helicobacter pylori infection. METHODSPatients with H. pylori infection were tested for CYP2C19 genotype as poor metabolizers (PMs) or extensive metabolizers (EMs, homozygous EM or heterozygous EM) and given rabeprazole for 7 days. Antibiotics (clarithromycin and amoxicillin) were given on days 1-4, days 4-7, or days 1-7. A direct link model with an effect compartment was used in the population pharmacokinetic-pharmacodynamic analysis. The status of H. pylori infection was evaluated. RESULTSRabeprazole clearance was lower in CYP2C19 PMs than in EMs (with average values of 10.7 vs. 16.8 l h -1 in PMs and EMs, respectively), resulting in higher plasma levels in the former group. The values of EC50 and keo of gastrin response increased with multiple doses of rabeprazole. The keo values were lower in CYP2C19 PMs than in EMs on day 1 (0.012 vs. 0.017 ¥ 10 -4 l min -1 ), and higher than in EMs on day 4 (0.804 vs. 0.169 ¥ 10 -4 l min -1 ) of rabeprazole treatment. The predicted gastrin-time profile showed a higher response in CYP2C19 PMs than in EMs on days 4 and 7.

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4-day triple therapy with rabeprazole, amoxicillin and clarithromycin in the eradication of Helicobacter pylori in patients with peptic ulcer disease - - A pilot study - -

Cited by 19 publications

References 14 publications

Seven‐day therapy for Helicobacter pylori in the United States

Seven‐day therapy for Helicobacter pylori in the United States

Time‐Dependent Amplified Pharmacokinetic and Pharmacodynamic Responses of Rabeprazole in Cytochrome P450 2C19 Poor Metabolizers

Pharmacokinetic– pharmacodynamic analysis of the role of CYP2C19 genotypes in short‐term rabeprazole‐based triple therapy against Helicobacter pylori

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