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High‐dose versus low‐dose esomeprazole‐based triple therapy for Helicobacter pylori infection

2007; Wiley; Volume: 37; Issue: 9 Linguagem: Inglês

10.1111/j.1365-2362.2007.01852.x

1365-2362

Ping‐I Hsu, Kwok‐Hung Lai, Chung-Jen Wu, Hui‐Hwa Tseng, Feng‐Woei Tsay, Nan‐Jing Peng, T. A. Chen, Seng‐Kee Chuah, Weir-Sen Lin, Gin‐Ho Lo,

Gastrointestinal disorders and treatments

Abstract Background This prospective, randomized, controlled study was conducted to compare the efficacies of high‐dose and low‐dose esomeprazole‐based triple therapies for Helicobacter pylori eradication in Taiwan. Materials and methods From January 2004 to June 2006, 240 H. pylori ‐infected patients were randomly assigned to undergo high‐dose (40 mg b.d.) or low‐dose (40 mg o.d.) esomeprazole combined with clarithromycin (500 mg b.d.) and amoxicillin (1 g b.d.) for one week. Follow‐up endoscopy was performed at eight weeks after the end of treatment to evaluate the response to therapy. Results Intention‐to‐treat analysis demonstrated no differences between eradication rates of high‐dose and low‐dose groups (92% vs. 90%, respectively, P > 0·05). Per‐protocol analysis yielded comparable results (95% vs. 93%). Both groups exhibited similar frequencies of adverse events (13% vs. 11%) and drug compliance (96% vs. 93%). Multivariate analysis indicated that only good compliance (odds ratio: 10·3, 95% CI, 3·0–35·7) was an independent predictor of treatment success. Conclusions This work demonstrates that low‐dose esomeprazole‐based triple therapy yields a similar eradication rate as high‐dose esomeprazole‐based therapy in Taiwan. Since the cost of the low‐dose regime is lower than that of the high‐dose regime, low‐dose esomeprazole‐based triple therapy can reasonably be recommended for the first‐line eradication of H. pylori for Taiwanese and probably most Asians.