A Non-Inferiority Study: Modified Dual Therapy Consisting Higher Doses of Rabeprazole Is as Successful as Standard Quadruple Therapy in Eradication of Helicobacter pylori

Abstract

The aim is to compare high-dose rabeprazole and amoxicillin containing modified dual therapy (MDT) with bismuth subcitrate containing standard quadruple therapy (SQT) as the first-line Helicobacter pylori eradication treatment in terms of efficacy, safety, and adherence to treatment. A total of 200 consecutive patients diagnosed endoscopically with nonulcer dyspepsia with H. pylori infection were randomly assigned into 2 groups, 1 treated with amoxicillin 750 mg thrice daily plus rabeprazole 20 mg thrice daily (MDT group) or rabeprazole 20 mg b.i.d., bismuth subcitrate 120 mg q.i.d., tetracycline 500 mg q.i.d., metronidazole 500 mg t.i.d. (SQT group). Overall, 196 patients (98 in the MDT group and 98 in the SQT group) completed the study. H. pylori eradication was achieved in 84.7% of patients in the MDT group by intention to treat analysis and 84.9% by per-protocol analysis, which were comparable with SQT group (87.8% and 88.8%, respectively). Adverse events including nausea (P = 0.03), dysgeusia (P < 0.001), diarrhea (P = 0.001), black colored stool (P < 0.001), headache (P = 0.01), and abdominal pain (P = 0.05) were significantly higher in SQT group. The MDT is an efficient and safe treatment choice that could be recommended in the first-line eradication treatment of H. pylori.

High dose PPI-amoxicillin dual therapy for the treatment of Helicobacter pylori infection: a systematic review with meta-analysis

“… 26 – 40 The characteristics of the included trials are shown in Table 1 . Of the 15 trials, 11 were conducted in Asia, 29 – 33 , 35 – 40 3 in Europe, 27 , 28 , 34 and 1 in North America. 26 HDDT was given three times daily in four trials, 26 , 28 , 30 , 34 and four times daily in the others.…”

“…Of the 15 trials, 11 were conducted in Asia, 29 – 33 , 35 – 40 3 in Europe, 27 , 28 , 34 and 1 in North America. 26 HDDT was given three times daily in four trials, 26 , 28 , 30 , 34 and four times daily in the others. 27 , 29 , 31 – 33 , 35 – 40 Six trials used TT, 26 , 28 – 31 , 36 seven used BQT, 27 , 33 – 35 , 37 , 38 , 40 one used non-BQT, 39 and one used both TT and ST as control regimen.…”

“… 26 HDDT was given three times daily in four trials, 26 , 28 , 30 , 34 and four times daily in the others. 27 , 29 , 31 – 33 , 35 – 40 Six trials used TT, 26 , 28 – 31 , 36 seven used BQT, 27 , 33 – 35 , 37 , 38 , 40 one used non-BQT, 39 and one used both TT and ST as control regimen. 32 Nine trials recruited treatment-naive patients, 30 , 33 – 40 four recruited treatment-experienced patients, 27 – 29 , 31 one recruited both, 32 and one did not report treatment experience of included patients.…”

“… 27 , 29 , 31 – 33 , 35 – 40 Six trials used TT, 26 , 28 – 31 , 36 seven used BQT, 27 , 33 – 35 , 37 , 38 , 40 one used non-BQT, 39 and one used both TT and ST as control regimen. 32 Nine trials recruited treatment-naive patients, 30 , 33 – 40 four recruited treatment-experienced patients, 27 – 29 , 31 one recruited both, 32 and one did not report treatment experience of included patients. 26 Of the 15 included trials, 12 were published as full-length articles, 26 – 34 , 37 – 39 whereas 3 were conference abstracts.…”

“… 32 Nine trials recruited treatment-naive patients, 30 , 33 – 40 four recruited treatment-experienced patients, 27 – 29 , 31 one recruited both, 32 and one did not report treatment experience of included patients. 26 Of the 15 included trials, 12 were published as full-length articles, 26 – 34 , 37 – 39 whereas 3 were conference abstracts. 35 , 36 , 40 …”