Polaprezinc, a mucosal protective agent in combination with lansoprazole, amoxicillin and clarithromycin increases the eradication rate of Helicobacter pylori infection

Kashimura, Hiromasa; Suzuki, Kaoru; Hassan, Mohamed Abdi; Ikezawa, Kazuto; Sawahata, Tadashi; Watanabe, Tôru; Nakahara, Atsuo; Mutoh, Hiroshi; Tanaka, Naohide

doi:10.1016/s0016-5085(98)80681-1

Cited by 7 publications

(12 citation statements)

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“…The pooled eradication rate from 23 treatments with lansoprazole, clarithromycin and amoxycillin (LCA) 23 , 31 , 40 , 51 , 62 , 85 –100 was 76.8% ( n = 975/1270). Rates ranged from 24% 40 to 92%.…”

Section: Resultsmentioning

confidence: 99%

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

Pipkin

Williamson

Wood

1998

Aliment Pharmacol Ther

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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.

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Section: Resultsmentioning

confidence: 99%

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

Pipkin

Williamson

Wood

1998

Aliment Pharmacol Ther

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“…[2][3][4] However, recent data suggest that the efficacy of these therapies is decreasing worldwide. [5][6][7][8][9][10][11][12] Indeed, the success rate in most European and Asian countries, as well as in the US and Canada, has declined to unacceptable levels with . 1 in 5 patients failing eradication therapy, and cure rates as low as 20-45% have been recently reported.…”

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confidence: 99%

The sequential therapy regimen for Helicobacter pylori eradication: a pooled-data analysis

Zullo

Francesco

Hassan

et al. 2007

Gut

266

187

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Background: Standard triple therapies are the most used treatment in clinical practice. However, a critical fall in the H pylori eradication rate following these therapies has been observed in the last few years. The sequential regimen is a novel, promising therapeutic approach. Objectives: To evaluate the available data on the sequential therapy regimen. Methods: A pooled-data analysis of all studies on the sequential regimen was performed. The eradication rate was calculated according to gastroduodenal pathology, proton pump inhibitor used, antibiotic resistance, as well as setting (paediatric or geriatric patients). Compliance, side effects, and cost implications were also evaluated. Results: Overall, more than 1800 patients have been treated with the sequential regimen. Such a therapy was superior to 7-10 days triple therapies in paediatric, adult and elderly patients, achieving an eradication rate constantly higher than 90% at ITT analysis. Although primary clarithromycin resistance reduced the efficacy of such a therapy, a success rate significantly higher than that observed with the standard 7-10 days triple therapies was found. Conclusion: The 10-day sequential treatment regimen achieves higher eradication rates than standard triple therapies.

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“…Six kinds of mucosal defensive agents, rebamipide, ecabet sodium, polaprezinc, plaunotol, sofalcon, sucralfate, and maalox dry suspension granule, were included in the selected studies. The ITT based eradication rates as well as the relative risks, comparing regimens with mucosal defensive agents to those without, in the selected studies were summarized in Table 1 for dual therapy regimens and in Table 2 for triple therapy regimens 32 –48 …”

Section: Resultsmentioning

confidence: 99%

“…Many studies which discuss the efficacy of mucosal defensive agents in eradicating H. pylori or serve as review articles on the subject have been reported 32 –48 . However, there is no article available in which each result is systematically combined and surveyed using statistical methods, and so we assessed the efficacy of mucosal defensive agents when used in combination with ordinary dual or triple therapies using statistical analysis.…”

Section: Discussionmentioning

confidence: 99%

Do mucosal defensive agents improve the cure rate when used with dual or triple therapy regimens for eradicating Helicobacter pylori infection?

Hojo

Miwa

Kikuchi

et al. 2000

Aliment Pharmacol Ther

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Background: Some of mucosal defensive agents have anti‐Helicobacter pylori activities. However, their effectiveness in eradicating H. pylori infection has not been evaluated. Aim: To assess the additive effect of mucosal defensive agents in eradication regimens using statistical analysis. Methods: Pertinent studies were retrieved using the Medline and the Igaku–chuo–zasshi databases in Japan, reference and congress abstract lists. Studies in which regimens consisted of dual or triple therapy with mucosal defensive agents and without them, were selected from the retrieved studies. Eradication rates were extracted from studies according to intention‐to‐treat analysis. We evaluated the efficacies of mucosal defensive agents by pooled relative risk of eradication rates and its 95% confidence intervals (95% CI), which were calculated by Mantel–Haenszel method. Heterogeneity among the studies in treatment effect was evaluated by a χ2‐test. Results: In dual therapy regimens, mucosal defensive agents demonstrated significant additive effects (pooled relative risk 1.41; 95% CI: 1.24–1.61). In triple therapy regimens, these agents did not provide significant additive effect. The clinical usefulness of specific agents could not be established, when each agent was analysed independently. Conclusions: Mucosal defensive agents improve the cure rate when used with existing dual therapy regimens for eradicating H. pylori infection.

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Polaprezinc, a mucosal protective agent in combination with lansoprazole, amoxicillin and clarithromycin increases the eradication rate of Helicobacter pylori infection

Cited by 7 publications

References 0 publications

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

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

The sequential therapy regimen for Helicobacter pylori eradication: a pooled-data analysis

Do mucosal defensive agents improve the cure rate when used with dual or triple therapy regimens for eradicating Helicobacter pylori infection?

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