Comparison of efficacies of dual therapy and triple therapy using rabeprazole in second‐line eradication of Helicobacter pylori in Japan

Abstract

SUMMARY BackgroundThe only authorized second-line Helicobacter pylori regimen in Japan is proton pump inhibitor + amoxycillin + clarithromycin. However, it has been reported that this second-line regimen is not effective. In this study, we evaluated the efficacy of dual and triple eradication therapies using rabeprazole as second-line H. pylori eradication regimens.

Impact of Quadruple Regimen of Clarithromycin Added to Metronidazole‐Containing Triple Therapy AgainstHelicobacter pyloriInfection Following Clarithromycin‐Containing Triple‐Therapy Failure

“…This is because the rate of secondary resistance to CAM reaches 64–78% following failure of CAM‐containing first‐line therapy [3,8]. Therefore, there is an urgent need to establish a standard second‐line treatment, and many clinical trials of such treatment consisting of PPI, AMPC, and metronidazole (MNZ) administered for 1 week have been reported in Japan [3,9–13]. These reports showed the high efficacy and safety of MNZ‐based triple therapy for second‐line eradication of H. pylori infection, and this regimen was approved as second‐line therapy in September 2007.…”

Tailored eradication therapy based on fecal Helicobacter pylori clarithromycin sensitivities

“…High eradication rates, namely 88%, 91%, and 96.7%, have been reported with this PPI/AM regimen in Japan 19–21 . In particular, an eradication rate of 91% in CAM‐resistant strains was reported by Isomoto et al ., 19 and 100% by Kawai et al 21 . In this study, we trialed a tailored eradication regimen, administering a PPI/AC regimen to subjects with CAM‐sensitive strains, and a PPI/AM regimen to subjects with CAM‐resistant strains.…”

“…The Japanese Society for Helicobacter Research recommends a PPI + AMPC + MNZ (PPI/AM) regimen as the secondary eradication regimen. High eradication rates, namely 88%, 91%, and 96.7%, have been reported with this PPI/AM regimen in Japan 19–21 . In particular, an eradication rate of 91% in CAM‐resistant strains was reported by Isomoto et al ., 19 and 100% by Kawai et al 21 .…”

Quadruple therapy with ecabet sodium, omeprazole, amoxicillin and metronidazole is effective for eradication of Helicobacter pylori after failure of first-line therapy (KDOG0201 Study)

“…Second‐line eradication therapy is a 1‐week, oral triple regimen combining a proton‐pump inhibitor, amoxicillin and metronidazole. Eradication rates of 80% or higher have been reported (1–4). However, increased numbers of resistant strains, a problem universally associated with the treatment of infection, are likely to emerge for metronidazole.…”