High‐dose ecabet sodium improves the eradication rate of Helicobacter pylori in dual therapy with lansoprazole and amoxicillin

Abstract

Aim: The additive effect of ecabet sodium in combination with dual therapy on Helicobacter pylori eradication was evaluated. Methods: H. pylori‐positive chronic gastritis patients were randomly assigned to one of the following three groups and medicated for 2 weeks. Group LA: dual therapy (lansoprazole 30 mg o.d. plus amoxicillin 750 mg b.d.). Group LA1E: dual therapy plus ecabet sodium (1 g b.d.). Group LA2E: dual therapy plus ecabet sodium (2 g b.d.). Patients were evaluated 4 weeks after the cessation of treatment by culture and 13C‐urea breath test. Results: Seventy‐one patients (mean age, 56.6 years; range, 26–79 years; 40 males, 31 females) were enrolled in this prospective, single‐blind study, and 68 completed the protocol. The eradication rates per protocol patient were 43% in group LA, 62% in group LA1E, and 79% in group LA2E, and those on the intention‐to‐treat basis were 42% in group LA, 57% in group LA1E and 79% in group LA2E. The eradication rate in group LA2E was significantly higher than group LA (P=0.032 in per protocol, P=0.022 in intention‐to‐treat). Adverse effects were observed in 10 patients in this study. There were no severe adverse effects caused by ecabet sodium. Conclusion: High‐dose ecabet sodium increases eradication rates of H. pylori in dual therapy with lansoprazole and amoxicillin.

Ecabet sodium inhibitsHelicobacter pylorilipopolysaccharide-induced activation of NADPH oxidase 1 or apoptosis of guinea pig gastric mucosal cells

“…Ecabet improves the efficacy of antibiotic therapy for H. pylori-infected patients with peptic ulcer (1,16) and has been suggested to exert unknown anti-H. pylori actions besides inhibition of urease activity (1,16). In this study, we found that ecabet inhibited the H. pylori LPStriggered expression of both Nox1 and Noxo1 mRNAs in the 10% FBS-containing medium, resulting in complete inhibition of the priming effect of H. pylori LPS (Fig.…”

“…Cells treated with 20 mg/ml ecabet or with 20 mg/ml ecabet plus 20 EU/ml H. pylori LPS, respectively, released 2.66 Ϯ 0.71 (n ϭ 4) or 2.42 Ϯ 0.36% (n ϭ 4) of the activity during the same period. Thus the concentrations used in this study were not toxic and may be clinically relevant, because patients are usually taking ecabet 1 (1) or 2 g twice a day (16).…”

“…This agent has a high affinity for gastric mucus and is known to inhibit pepsin (29) and urease activities (15). Ecabet is also suggested to improve efficacy of antibiotic therapy for H. pylori infection in patients with peptic ulcer (1,16). A recent study showed that ecabet inhibited transcription of the IL-8 gene and secretion of IL-8 by gastric epithelial cells infected with H. pylori at a concentration of 5 mg/ml.…”

Triple Therapy with Ecabet Sodium, Amoxicillin and Lansoprazole for 2 Weeks as the Rescue Regimen for H. pylori Infection

“…Several reports have demonstrated that ecabet sodium used with any of several regimens increases the eradication rate of H. pylori infection: Ohkusa et al (22) reported that ecabet sodium increased the eradication rates of dual therapy with lansoprazole and amoxicillin from 58% to 78%; Kagaya et al (23) reported that this agent increased the eradication rate by dual lansoprazole/amoxicillin therapy from 43% to 79%; and Kim et al (24) reported that it increased the eradication rate with triple PPI/amoxicillin/clarithromycin therapy from 78.8% to 88.6%. In the present study, therefore, we examined the eradication rates of ecabet sodiumbased regimens, such as LAC2E for 1 week and LA2E for 2 weeks, in comparison with LAC for 1 week in patients in whom eradication of H. pylori with the triple PPI/amoxicillin/clarithromycin therapy had failed.…”

Ecabet sodium induces neuronal nitric oxide synthase-derived nitric oxide synthesis and gastric adaptive relaxation in the human stomach

“…Many reports have documented the effects of ES on peptic ulcers [13] as well as ulcerative colitis [14]. ES has an antibacterial effect on Helicobacter pylori and accelerates the eradication rate of Helicobacter pylori in vivo [15][16][17]. Lee et al [18] reported the effects of ES in FD patients in a prospective, double-blinded, randomized trial.…”