Helicobacter pylori eradication therapy: Three different one-week regimen comparisons

Aim: To evaluate the effectiveness of triple therapy containing either omeprazole or ranitidine bismuth citrate (RBC) to treat H. pylori infection in Vietnamese duodenal ulcer patients. Methods: Patients infected with H. pylori were randomized to receive either omeprazole (20 mg b.d.), clarithromycin (500 mg b.d.) and amoxycillin (1 g b.d.) for 10 days (OAC), or RBC (400 mg b.d.), clarithromycin (500 mg b.d.) and amoxycillin (1 g b.d.) for 10 days (RAC). H. pylori eradication and ulcer healing was established by a follow‐up oesophagogastroduodenoscopy (EGD) at least 4 weeks after therapy. Side‐effects and compliance were assessed. Results: One hundred and four out of 108 (96%) patients with a duodenal ulcer were infected with H. pylori. Eighty per cent of infected patients had detectable CagA IgG antibodies. Fifty‐seven patients received OAC and 47 received RAC. OAC eradicated H. pylori in 91 and 86% of patients by per protocol (PP) and intention‐to‐treat (ITT) analysis, respectively. PP and ITT eradication rates for RAC were 96 and 91%. Ulcer healing at the follow‐up EGD was 89% with OAC and 100% with RAC. Side‐effects were minor. No patient failed to complete the protocol due to side‐effects. Conclusion: Triple therapy with either omeprazole or RBC is highly effective in eradicating H. pylori and healing duodenal ulcer in Vietnamese patients.

Section: Discussionmentioning

confidence: 81%

Omeprazole or ranitidine bismuth citrate triple therapy to treat Helicobacter pylori infection: a randomized, controlled trial in Vietnamese patients with duodenal ulcer

Hv¹,

Long

et al. 2000

“…Reports of 10 studies with ranitidine bismuth citrate, clarithromycin and amoxycillin (RCA) were found 13–22. ITT eradication rates were available from all but one,22 giving a pooled rate of 82.0% ( n = 427/521); range 39–94% 19.…”

Section: Resultsmentioning

confidence: 99%

“…Forty‐seven studies of 1‐week triple therapy with omeprazole, clarithromycin and amoxycillin (OCA) were identified, from which the ITT eradication rate could be determined 14 , . 17 , 19 , 20 , 23 –65 It was unavailable from another 19 studies 66 –84 …”

Section: Resultsmentioning

confidence: 99%

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One‐week clarithromycin triple therapy regimens for eradication of Helicobacter pylori

Pipkin

Williamson

Wood

1998

Background: One‐week triple therapies have been endorsed as the treatment regimens of choice for eradication of Helicobacter pylori infection. Those that include clarithromycin appear to be the most effective. Aim: To review reports of triple therapies that include clarithromycin. Methods: Reports were identified from the literature to May 1998. The variation between study designs prevents a formal meta‐analysis. A measure of the relative efficacies of regimens has, however, been gained by comparison and by pooling of intention‐to‐treat eradication rates. Results: One hundred and ninety‐two studies were identified which included 264 treatment arms of a 1‐week triple therapy composed of clarithromycin with amoxycillin or a nitroimidazole (metronidazole or tinidazole), and either ranitidine bismuth citrate or a proton pump inhibitor (omeprazole, lansoprazole or pantoprazole). From reports of these studies, an intention‐to‐treat H. pylori eradication rate could be determined from 210 treatment arms of 151 studies. Conclusions: There is little to choose between the efficacies of 1‐week clarithromycin‐based triple therapy eradication regimens. However, those comprising clarithromycin, a nitroimidazole and either ranitidine bismuth citrate or a high dose of omeprazole are, in general, the most effective. Against antibiotic‐resistant strains of H. pylori, regimens including ranitidine bismuth citrate may be more effective than those including a proton pump inhibitor.

“…Several studies using 1‐week dual therapy with RBC and clarithromycin have shown intention‐to‐treat eradication rates of 75–87% 20 . 33 –35 Recently, it was shown that this combination is as effective as RMC 20 . Consequently, it is possible that the metronidazole could be omitted.…”

Section: Discussionmentioning

confidence: 99%

The influence of metronidazole resistance on the efficacy of ranitidine bismuth citrate triple therapy regimens for Helicobacter pylori infection

Wouden

Thijs

Zwet

et al. 1999