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A multicenter study to compare the efficacy and safety of 3 7-day rabeprazole (RAB)-based triple therapy regimens for Helicobacter pylori (Hp) eradication

2003; Elsevier BV; Volume: 124; Issue: 4 Linguagem: Inglês

10.1016/s0016-5085(03)81821-8

1528-0012

Schlioma Zaterka, Laércio Tenório Ribeiro, Edson da Silva, Jorge Jorge, Carlos Feitosa, José Alves de Freitas, J L P Módena, Luiz Gonzaga Vaz Coelho, Jaime Natan Eisig,

Microbial Metabolites in Food Biotechnology

PPl-iuduced high gastric pH is reported to increase the sensitivity of H. pylori to antimicrobial agents.Rabeprazole, a recently developed PPl, has demonstrated a faster onset of antisecretory activity and stronger anti-microbial activity than other PPIs.This faster onset of anti-secretory activity may yield favorably results in patients taking short duration PPl-based eradication therapy.It has not been established whether pretreatment with omeprazole before PPI-based triple therapy can compensate for the slow onset of anti-secretory activity of omeprazole, with resulting improvement in the eradication rates for short duration omeprazole-based eradication therapies.This study was performed to evaluate the efficacy of 5-day rabeprazole-based eradication therapy for H. pylori and pretreatment with omeprazole for 5-day omeprazole-based therapy, in a randomized multicenter study.Subjects and Methods: Subjects were 120 H. pylori positive patients (86 men and 34 women, with a mean age of 55.8 yr, comprising 51 subjects with gastric ulcers, 37 with duodenal ulcers, 3 with gastroduodenal ulcers, 2 who had received endoscopic treatment for early gastric cancer, 8 with gastric hyperplastic polyps, and 15 with gastritis accompanied by dyspepsia).They were randomly assigned to one of three 5 day regimens: rabeprazole 20 mg b.i.d, amoxycillin 500 mg t.i.d., and clarithrumycin 400 mg b.i.d.(RAC regimen: 40 patients), or omeprazole 20 mg b.i.d., amoxycillin 500 mg t.i.d., and clarithromycin 400 mg b.i.d.without (OAC1 regimen: 40 patients) and with (OAC2 regimen: 40 patients) 5 days of pretreatment with omeprazole 20 mg b.i.d.Eradication was assessed by a 13C urea breath test 1 month after completion of treatment.Results: Intention-to-treat, all-patients-treated, and per protocol eradication rates for the RAC group were 90%, 90%, and 92%, respectively, in the OAC1 group they were 75%, 75%, and 83%, respectively, and in the OAC2 group 85%, 87%, and 90% respectively.Conclusion: Five day rabeprazole-based triple therapy is effective for H. pylon eradication, and pretreatment with omeprazole may improve the eradication rate for 5 day omeprazole-based therapy.