Influence of pretreatment with H2 receptor antagonists on the cure rates of Helicobacter pylori eradication

Tokoro, Chikako; Inamori, Masahiko; Koide, Tomoko; Sekino, Yusuke; Iida, Hiroshi; Sakamoto, Yasunari; Endo, Hideki; Hosono, Kunihiro; Takahashi, Hirokazu; Yoneda, Masato; Yasuzaki, Hiroaki; Ogawa, Masami; Abe, Yasunobu; Kubota, Kensuke; Saito, Satoru; Kawana, Ichiro; Maeda, Shin; Matsuda, Reikei; Takahashi, Daisuke

doi:10.12659/msm.881762

Cited by 8 publications

(7 citation statements)

References 34 publications

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“…A large number of other studies looked at the role of phytomedicine in H. pylori eradication therapy. In vitro anti-H. pylori activity was observed when the Terminalia macroptera root was used and also for Eucalyptus tolleria leaf extract (when used with clarithromycin) [53,54]. Interestingly, in drug-resistant strains, Combretum molle and Sclerocarya birrea were shown to be potentially effective in vitro [55,56].…”

Section: Adjuvant Therapymentioning

confidence: 99%

Treatment of Helicobacter pylori infection 2012

et al. 2012

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Helicobacter pylori resistance rates to antibiotics vary in different countries and even in different regions of the same country. Choice of treatment is strongly dependent on antibiotic resistance rates. In some countries, triple therapy with a proton-pump inhibitor, amoxicillin, and clarithromycin is still the best option, but eradication results fall short of what would be desired (90-95%) in countries with clarithromycin resistance >20%, bismuth-containing quadruple therapy, or nonbismuth sequential or concomitant therapies may then be the preferred option. Newer antibiotic regimens are awaited. Vaccination would be the best option, especially for developing countries, but little progress has been made in designing a vaccine.A considerable amount of work has been conducted over the last year assessing many issues around Helicobacter pylori eradication therapy. These focussed primarily on assessing the efficacy of current standard triple therapy and exploring new first-line treatments. There was also progress in investigating antibiotic resistance rates, and the rescue therapies required to deal with ensuing treatment failures. There has also been an evolution in the use of adjunctive therapies. This article will address the published literature over the last year pertaining to these topics. Triple TherapyNumerous studies over the last year have assessed the efficacy of standard triple therapy with amoxicillin, clarithromycin, and a proton-pump inhibitor for the eradication of H. pylori, which have been perceived to be in decline in recent years. One such study looked at cure rates reported in all published literature from Spain between 1997 and 2008 and found that while cure rates have in fact been stable over that period, they remain inadequate with a mean cure rate of 80% by intention-to-treat and 83% by per-protocol [1]. Similar results were obtained from a multicenter study in Japan that revealed an eradication rate of 80.7% with an incidence of adverse drug reactions of 4.4% [2]. Other studies have looked at whether the efficacy of triple therapy can be improved by prolonging the course of therapy. In China, a study of shorter regimens showed eradication rates of 76, 89, and 91% for 3-day, 5-day, and 7-day regimens, respectively [3]. Increasing efficacy by prolongation of therapy was also noted in Greek patients, with eradication rates of 74.5% for 7 days, 80.6% for 10 days, and 90.2% for 14 days of therapy [4]. Another study showed that efficacy could be maintained when lower doses of medications were given, which reduced costs and side effects with cure rates of 77.2% for 10 mg rabeprazole, 500 mg amoxicillin, and 250 mg clarithromycin vs 78.9% for the standard 20 mg, 1 g, and 500 mg doses of these drugs [5].Regardless of the type of therapy used, study from Canada showed widespread failure to comply with test and treat in up to 10% of cases and a failure to confirm eradication in 32% [6]. This illustrates that efficacious first-line therapy will always depend on adherence to guidelines by phy...

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Section: Adjuvant Therapymentioning

confidence: 99%

Treatment of Helicobacter pylori infection 2012

et al. 2012

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“…As H2RA does not influence H. pylori transformation, theoretically, H2RA pretreatment might be more suitable to improve the H. pylori eradication efficacy than PPI. A retrospective study has observed that the H2RA pretreatment group achieved a marginally higher H. pylori eradication rate when compared to the standard triple therapy group (81.6% vs. 77.6%, p = 0.3799) (Tokoro et al 2011), suggesting the possibility of H2RA pretreatment for H. pylori eradication; however, it was limited by the retrospective nature, including heterogeneous H. pylori eradication regimen, various durations (1-150 days) of H2RA pretreatment, and diverse kinds and dosages of H2RA. Thus, the previous retrospective study is insufficient to evaluate the effect of H2RA pretreatment on H. pylori eradication efficacy.…”

Section: Discussionmentioning

confidence: 99%

“…The primary outcome was the success rates of H. pylori eradication after completion of the entire regimen. Based on a previous study in a similar setting, the sample size was calculated assuming an 85% eradication rate as the primary endpoint in the pretreatment group and 70% in the control group (Tokoro et al 2011;Kim et al 2015). We estimated that a sample size of 120 patients per group would have a statistical power of 80% and a two-sided α-risk of 0.05.…”

Section: Discussionmentioning

confidence: 99%

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Pretreatment with Ranitidine Bismuth Citrate May Improve Success Rates of <i>Helicobacter pylori</i> Eradication: A Prospective, Randomized, Controlled and Open-Label Study

Yoon

Kwak

Jeon

et al. 2021

Tohoku J. Exp. Med.

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Effective Helicobacter pylori (H. pylori) eradication is a major public health concern; however, eradication failure rates with the standard triple therapy remain high. We aimed to investigate the effectiveness and tolerability of ranitidine bismuth citrate (RBC) pretreatment before standard triple therapy for H. pylori eradication. A prospective, randomized, controlled, and open-label clinical trial was conducted from June to December 2019. H. pylori eradication rate, safety, and tolerability were compared between the standard treatment group (esomeprazole, amoxicillin, and clarithromycin for 7 days) and RBC pretreatment group (RBC for 2 weeks before standard triple therapy). This trial ended earlier than estimated owing to the N-nitrosodimethylamine concerns with ranitidine. Success rates of H. pylori eradication were 80.9% and 67.3% in the RBC pretreatment (n = 47) and standard treatment (n = 52) (p = 0.126) groups, respectively. Our trial was discontinued earlier than planned; however, a statistical significance would be achieved by expansion of our data (p = 0.031) if patient enrollment numbers reached those initially planned. Adverse event rates were comparable between groups (25.5% in the pretreatment group vs. 28.8% in the standard treatment group), without serious event. Tolerability was excellent in both groups, recorded as 97.9% and 100% in the pretreatment and standard treatment groups, respectively. Compared with the standard triple regimen, RBC pretreatment for 2 weeks may achieve higher H. pylori eradication rates, with excellent safety and tolerability. However, this study necessitates further validation as it was discontinued early owing to the N-nitrosodimethylamine issues of ranitidine.

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“…On the other hand, the effect of pretreatment with H2 receptor antagonist (H2RA) is unclear. Only one report suggested that pretreatment with H2RA had no significant influence on the efficacy of H. pylori eradication treatment [13]. The present retro-spective study analyzed whether pretreatment with PPI or H2RA decreases or dose not decrease the probability of H. pylori eradication.…”

Section: Introductionmentioning

confidence: 90%

The Influence of Pre-Treatment with a Proton Pump Inhibitor / H2 Receptor Antagonists on Helicobacter pylori Eradication

Horii¹,

Konishi²,

Kanbayashi³

2020

JJGH

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Vonoprazan (VPZ) is more useful than proton pump inhibitor (PPI)-based regimen as H. pylori eradication therapy. It is controversial whether pretreatment with H2 receptor antagonist (H2RA) or PPI before H. pylori eradication treatment increases or decreases the eradication rate. In this retrospective study, 802 patients with H. pylori infection were treated. We compared the efficacy of eradication regimen [VPZ (n=202), esomeprazole (EPZ) (n=198), sodium rabeprazole (RPZ) (n=200) or lansoprazole (LPZ)(n=202)/amoxicillin/clarithromycin] in patients with H. pylori infection with or without H2RA or PPI pretreatment. Analysis of variance, Tukey-Kramer multiple-comparison test and logistic regression analysis were used. In VPZ group, the eradication rate of non-received pretreatment group (94.7%) was significantly higher than PPI (75.0% p = 0.0085) and H2RA (73.7% p = 0.0116) pretreatment received group in the per protocol (PP) analysis. In EPZ, RPZ and LPZ group, no significant difference in the eradication rate was observed between non-received pretreatment group and PPI / H2RA pretreatment received group. Multivariate analysis showed that non-pretreatment of PPI or H2RA was predicting factor. Pretreatment with PPI and H2RA decreases the probability of H. pylori eradication in VPZ-based triple therapy.

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Influence of pretreatment with H2 receptor antagonists on the cure rates of Helicobacter pylori eradication

Cited by 8 publications

References 34 publications

Treatment of Helicobacter pylori infection 2012

Treatment of Helicobacter pylori infection 2012

Pretreatment with Ranitidine Bismuth Citrate May Improve Success Rates of <i>Helicobacter pylori</i> Eradication: A Prospective, Randomized, Controlled and Open-Label Study

The Influence of Pre-Treatment with a Proton Pump Inhibitor / H2 Receptor Antagonists on Helicobacter pylori Eradication

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