Does Pretreatment with Lansoprazole Influence Helicobacter pylori Eradication Rate and Quality of Life?

Abstract

Background/Aims: It is controversial whether pretreatment with a proton pump inhibitor (PPI) before Helicobacter pylori eradication treatment decreases the eradication rate. To determine the effects of pretreatment with lansoprazole alone, followed by an H. pylori eradication regimen (lansoprazole 30 mg, amoxicillin 750 mg and clarithromycin 200 mg twice daily for 1 week), on the eradication rate and quality of life (QoL) of the patient. Methods: Patients with H. pylori-positive peptic ulcer were randomly assigned to two groups. The patients received either lansoprazole (30 mg) once daily for 6–8 weeks before H. pylori eradication (group A), or eradication treatment and then lansoprazole (30 mg) for 6–8 weeks (group B). To assess the QoL of the patients, the Gastrointestinal Symptom Rating Scale (GSRS) questionnaire was evaluated. Results: A total of 116 patients were enrolled. The cure rates were 78.9% in group A and 78.0% in group B. In both groups, GSRS analysis showed a significant improvement of the overall GSRS score at the assessment of eradication efficacy, compared to baseline; there was no difference between the groups. Conclusion: With this H. pylori eradication regimen, there was no difference in the cure rates and QoL associated with PPI pretreatment.

Helicobacter pylori eradication improves the quality of life regardless of the treatment outcome

“…Several other authors have reported that the epigastric symptoms and QOL of Hp-positive patients with GERD, FD, and peptic ulcers were significantly improved by the eradication of Hp. [10,11,20] However, these previous studies only evaluated the symptoms and QOL in patients who succeeded with Hp eradication. In contrast, the present study evaluated all patients, regardless of the results of Hp eradication.…”

Triple Therapy with High‐Dose Proton‐Pump Inhibitor, Amoxicillin, and Doxycycline Is Useless for Helicobacter pylori Eradication: A Proof‐of‐Concept Study

“…Pretreatment with PPI is controversial, and a meta‐analysis showed no differences in eradication rates between patients with or without pretreatment . Some older data suggested that pretreatment with a PPI before the administration of H. pylori eradication therapy might decrease treatment efficacy, but the meta‐analysis and more recent articles do not confirm this information . Given the special circumstances of our patients, we decided that such a strategy, albeit a potential confounding factor, could be beneficial.…”

Optimizing proton pump inhibitors in Helicobacter pylori treatment: Old and new tricks to improve effectiveness

“…The authors theorized that PPIs might induce coccoid-persistent forms of H. pylori , less vulnerable to the antibiotics. Other studies have reported that pretreatment did not affect treatment outcome[32-34]. Inoue et al have reported that there was no statistically significant difference in the eradication rate with the regimen of lansoprazole, amoxicillin and clarithromycin between patients with and without pretreatment (lansoprazole 30 mg, once daily)[32].…”