A large-scale nationwide multicenter prospective observational study of triple therapy using rabeprazole, amoxicillin, and clarithromycin for Helicobacter pylori eradication in Japan

Fujioka, Toshio; Aoyama, Nobuo; Sakai, Kyoko; Miwa, Yoshiyuki; Kudo, Mineo; Kawashima, Junichi; Matsubara, Yasuo; Miwa, Jun; Yakabi, Koji

doi:10.1007/s00535-011-0487-6

Cited by 28 publications

(20 citation statements)

References 24 publications

(36 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Several studies have reported successful H. pylori eradiation rates using vonoprazan from Japan [25-28, 31-38]. These reports showed that eradication rates of vonoprazan therapy were 85.0–98.8%.…”

Section: Discussionmentioning

confidence: 87%

Vonoprazan, a Novel Potassium-Competitive Acid Blocker, Should Be Used for the Helicobacter pylori Eradication Therapy as First Choice: A Large Sample Study of Vonoprazan in Real World Compared with Our Randomized Control Trial Using Second-Generation Proton Pump Inhibitors for Helicobacter pylori Eradication Therapy

et al. 2018

View full text Add to dashboard Cite

Background/Aims: Phase III study demonstrated that vonoprazan-based Helicobacter pylori eradication therapy achieved higher eradication rate compared with lansoprazole. However, there is no study that evaluated the efficacy of vonoprazan in a large sample in real world. We investigated the eradication rate and safety of vonoprazan-based eradication therapy compared with our randomized control trial using second-generation proton pump inhibitor (PPIs). Methods: (First study) A total of 147 patients who have H. pylori infection were randomly assigned to receive either, esomeprazole (EPZ) group and rabeprazole (RPZ) group. (Second study) 1,688 patients who have H. pylori infection underwent primary eradication with triple therapy involving vonoprazan. In both studies, triple therapy with amoxicillin, clarithromycin, and PPI or vonoprazan was performed, and eradication effect was assessed by an urea breath test. Results: (First study) Eradication rate was 77.5% in the EPZ group and 68.4% in the RPZ group; no significant difference was observed between the 2 groups. (Second study) The successful primary eradication rate was 90.8%. There was no severe adverse effect. Conclusions: The eradication rate of vonoprazan-based triple therapy was remarkably higher compared with second-generation PPIs-based triple therapy in real world. Vonoprazan is very likely to become the first option for future eradication therapy.

show abstract

Section: Discussionmentioning

confidence: 87%

Vonoprazan, a Novel Potassium-Competitive Acid Blocker, Should Be Used for the Helicobacter pylori Eradication Therapy as First Choice: A Large Sample Study of Vonoprazan in Real World Compared with Our Randomized Control Trial Using Second-Generation Proton Pump Inhibitors for Helicobacter pylori Eradication Therapy

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Annual surveillance conducted between 2002 and 2006 for 5 years showed that the mean nationwide CAM resistance rates had increased from 18.9 (2002) to 27.2% (2006 [34]). A large-scale, nationwide, multicenter prospective study conducted between 2007 and 2009 showed a successful eradication rate of 80.7% when AMPC + CAM + RPZ was used as a first-line eradication regimen [35]. …”

Section: Management Of H Pylori In Japanmentioning

confidence: 99%

Helicobacter pyloriinfection in Japan

Shiota

Murakawi

Suzuki

et al. 2013

Expert Review of Gastroenterology & Hepatology

Self Cite

View full text Add to dashboard Cite

The prevalence of Helicobacter pylori infection is gradually decreasing in Japan. On the main island of Japan, nearly all H. pylori isolates possess cagA and vacA with strong virulence. However, less virulent H. pylori strains are frequently found in Okinawa where cases of gastric cancer are the lowest in Japan. Eradication therapy for peptic ulcer, idiopathic thrombocytopenic purpura, gastric mucosa-associated lymphoid tissue lymphoma and early gastric cancer after endoscopic resection has been approved by the Japanese national health insurance system. However, the Japanese Society for Helicobacter Research recently stated that all ‘H. pylori infection’ was considered as the indication for eradication irrespective of the background diseases. To eliminate H. pylori in Japan, the Japanese health insurance system should approve the eradication of all H. pylori infections.

show abstract

“…3a). A recent nationwide study also showed about 80% of eradication rate with the first-line therapy, indicating no further deterioration of the first-line therapy [31]. As for the second-line therapy after failure of the first-line therapy, eradication rates over 90% were achieved (fig.…”

Section: Resultsmentioning

confidence: 91%

“…The reduced doses were determined based on the clinical trials in Japan and showed equivalent efficacy to higher-dose regimens. Although we are facing increasing CAM-resistant strain of H. pylori now exceeding 20% [19], a reason why CAM-based triple therapy is not recommended as the first line [14], we still stick to the CAM-containing PPI triple therapy as the first line since an eradication rate of around 80% is maintained at least in our area and others as well [31]. Even if the first line fails, MNZ-containing triple therapy is a highly effective second-line therapy in Japan, thereby an eradication rate of over 95% can be achieved with these two regimens.…”

Section: Discussionmentioning

confidence: 99%

Clinical Management of <b><i>Helicobacter pylori</i></b> - The Japanese Perspective

Sugano

Osawa

Satoh

2014

Dig Dis

View full text Add to dashboard Cite

Background: After the approval of health insurance coverage of eradication therapy for Helicobacter pylori-positive peptic ulcer disease (PUD) in 2000, comprehensive coverage for H. pylori infection itself was implemented in 2013. Methods: We did a literature search using PubMed database on the management of H. pylori infection including indications, regimens, outcomes of current eradication therapies, trends of antibiotic resistance rates and proposed third-line rescue therapy in Japan. We also collected data on changes of eradication rates in our hospital by searching electronic medical records. Results: After implementation of insurance coverage of eradication therapy for PUD, dramatic reduction of the number patients with PUD as well as spending on ulcer drug was documented. According to the current regulation, proton pump inhibitor (PPI)-based triple therapy with 2 antibiotics, amoxicillin (AMPC) plus clarithromycin, for 7 days is approved as the first-line therapy. After failure of the first-line therapy, PPI plus AMPC and metronidazole is authorized as the second line, which maintains an excellent eradication rate of over 90% in Japan. When these two therapies fail, a sitafloxacin-based therapy seems to be most promising among many rescue regimens. Conclusion: Comprehensive public health insurance coverage of H. pylori infection will promote eradication in Japanese people infected with H. pylori, whose risk of developing gastric cancer has been shown to be high. It also provides us a unique opportunity to study whether the broader indications can accelerate the reduction of gastric cancer in Japan in the same way we witnessed the reduction of PUD.

show abstract

A large-scale nationwide multicenter prospective observational study of triple therapy using rabeprazole, amoxicillin, and clarithromycin for Helicobacter pylori eradication in Japan

Abstract: In a large-scale nationwide study of use in clinical practice, RAC therapy was confirmed to be effective and safe.

Cited by 28 publications

References 24 publications

Helicobacter pyloriinfection in Japan

Clinical Management of <b><i>Helicobacter pylori</i></b> - The Japanese Perspective

Contact Info

Product

Resources

About