Seven versus ten days of rabeprazole triple therapy for Helicobacter pylori eradication:: A multicenter randomized trial

被引:48
作者
Calvet, X
Ducons, J
Bujanda, L
Bory, F
Montserrat, A
Gisbert, JP
机构
[1] Hosp Sabadell, Digest Dis Unit, Barcelona, Spain
[2] Hosp San Jorge, Gastroenterol Unit, Huesca, Spain
[3] Hosp Donostia, Dept Gastroenterol, San Sebastian, Spain
[4] Hosp Mar, Dept Gastroenterol, Barcelona, Spain
[5] Hosp Princesa, Dept Gastroenterol, Madrid, Spain
关键词
D O I
10.1111/j.1572-0241.2005.50019.x
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
BACKGROUND: Ten-day triple therapy is somewhat more effective than 7-day treatment for curing Helicobacter pylori infection. Recent studies have suggested that rabeprazole-a proton pump inhibitor with fast onset of acid inhibition-could raise the efficacy of 7-day therapies to the levels obtained with 10-day treatment. OBJECTIVE: To compare the efficacy of 7- and 10-day rabeprazole-based triple therapy for H. pylori eradication. PATIENTS AND METHODS: Four hundred and fifty-eight patients were randomized to 7 or 10 days of triple therapy, including rabeprazole 20 mg, clarithromycin 500 mg, and amoxicillin 1 g, all twice a day. Cure rates were evaluated by urea breath test. RESULTS: Two hundred and thirty-seven patients received 7-day and 221 received 10-day therapy. Groups were comparable in terms of demographic variables. Intention to treat cure rates were 73.8% (95% CI: 67-79%) for 7-day and 79.6% (95%: CI:74-85%) for 10-day therapy (p= 0.09). Per-protocol cure rates were 81.8% (95% CI:76-o86%) and 89.3% (95% CI: 84-93%), p= 0.02, respectively. Cure rates were similar in peptic ulcer patients but in subjects without ulcer they were clearly lower for 7-day therapy: 66%versus 77% by intention to treat (p= 0.08) and 73%versus 91% in the per-protocol analysis (p= 0.004). Side effects and compliance in the two groups were comparable. CONCLUSIONS: Seven- and 10-day triple therapies seem equally efficient in peptic ulcer patients. In contrast, 7-day therapy is significantly less effective in nonulcer dyspepsia patients. Ten-day therapy, therefore, seems preferable when treating nonulcer patients.
引用
收藏
页码:1696 / 1701
页数:6
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