Incidence of duodenal ulcer healing after 1 week of proton pump inhibitor triple therapy for eradication of <i>Helicobacter pylori</i>

Harris, Adam; Misiewicz, J. J.; Bardhan, Karna Dev; Levi, S; O’Moráin, Colm; Cooper, Barrett R.; Kerr, G. D.; Dixon, M. F.; Langworthy, H; Piper, D. W.

doi:10.1046/j.1365-2036.1998.00362.x

Cited by 23 publications

(21 citation statements)

References 14 publications

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“…Nevertheless, the number of patients included and analysed in each group was comparable to that of previous randomised and published studies. 1,7,11 Although the confidence interval of the difference in healing observed in our study suggests little or no benefit for continued omeprazole treatment after 1 week, on the other hand one cannot exclude the possibility that such treatment increases the healing rate by as much as 13.7%. Larger and adequately powered studies will be needed to definitively address this issue.…”

Section: Discussioncontrasting

confidence: 59%

“…1 Furthermore, in this study, ulcers were healed in 28 out of 40 patients in whom H. pylori was not eradicated. 1 In another study, with a design similar to ours, all 52 patients had an ulcer, which was healed by 28 days, where the H. pylori cure rate was 96%. 2 In our study, as for other studies, the percentage of patients with healed ulcer was no different whether H. pylori was eradicated or not.…”

Section: Discussionmentioning

confidence: 57%

“…8 The results from our study permit similar conclusions to be reached to those proposed in other studies. 1,2 It suggests that 7-day triple therapy is a simple and sufficient treatment for the healing of an uncomplicated active peptic ulcer. However, this cannot be extended to complicated ulcers or those that have developed during NSAID treatment, which were excluded from our study, as well as from other published studies.…”

Section: Discussionmentioning

confidence: 99%

“…However, several studies have suggested that treatment for eradication of H. pylori without prolongation of anti-secretory treatment is sufficient to heal most of the duodenal ulcer. [1][2][3][4][5][6][7][8][9] The present study tests the hypothesis that the 1-week triple therapy for eradication of H. pylori alone is a convenient therapy regimen for uncomplicated H. pylori-associated duodenal ulcer.…”

Section: Introductionmentioning

confidence: 99%

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Duodenal ulcer healing with 1‐week eradication triple therapy followed, or not, by anti‐secretory treatment: a multicentre double‐blind placebo‐controlled trial

Colin

2002

Aliment Pharmacol Ther

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Background: In the management of Helicobacter pylori induced duodenal ulcer, it is still controversial whether anti‐secretory treatment needs to be continued following a 1‐week course of eradication therapy. Methods: 150 patients with H. pylori active duodenal ulcer (diameter ≥ 5 mm) were included. After a 1‐week eradication treatment combining omeprazole 20 mg b.d., amoxicillin 1000 mg b.d. and clarithromycin 500 mg b.d. (OAC), patients were randomized to omeprazole 20 mg or placebo for 3 additional weeks. The primary variable was ulcer healing assessed at 4 weeks. Eradication was verified 4 weeks after cessation of study drugs by 13C‐urea breath test. Intention‐to‐treat analysis (ITT) included 131 patients with positive histopathology at inclusion. Results: Healing rates were not statistically different, at 89% and 87%, respectively, in the OAC–omeprazole and OAC–placebo groups (95% CI: –8.7; 13.7). Numerically, healing rates in patients with successful eradication was higher [94/104 (90%)] than in patients with failed eradication [21/27 (78%)]. However, the difference was not statistically significant (P < 0.1). Conclusions: One‐week OAC eradication triple therapy achieves excellent healing rates in patients with uncomplicated duodenal ulcer disease. Although the confidence interval of the difference in healing suggests little or no benefit of continued omeprazole treatment after 1 week, larger studies are needed to address this issue definitively.

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Section: Discussioncontrasting

confidence: 59%

Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Duodenal ulcer healing with 1‐week eradication triple therapy followed, or not, by anti‐secretory treatment: a multicentre double‐blind placebo‐controlled trial

Colin

2002

Aliment Pharmacol Ther

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“…Twenty‐two studies fulfilled the inclusion criteria and contained data for at least one of the planned comparisons. For the main comparison, 18 studies reported ITT analysis and 20 PP analysis 8 –29 . Detailed characteristics of the studies are shown in Table 1.…”

Section: Resultsmentioning

confidence: 99%

Proton pump inhibitor, clarithromycin and either amoxycillin or nitroimidazole: a meta‐analysis of eradication of Helicobacter pylori

Gisbert

González

Calvet

et al. 2000

Aliment Pharmacol Ther

166

114

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Aim: To perform a meta‐analysis of studies comparing twice daily, one‐week triple therapy with a proton pump inhibitor, clarithromycin (C) and amoxycillin (A) (PCA) vs. those using proton pump inhibitor, clarithromycin and a nitroimidazole (N) (PCN) for H. pylori eradication. Review methods: Selection criteria: Comparative randomized trials of PCA vs. PCN were included. Data sources: PubMed database and abstracts from congresses until September 1999. Statistics: Meta‐analysis was performed combining the Odds Ratios (OR) of the individual studies in a global OR (Peto method) both on an intention‐to‐treat (ITT) and on a per protocol (PP) basis. Results: Twenty‐two studies fulfilled the inclusion criteria. Eighteen studies reported ITT and 20 PP analysis. Mean H. pylori eradication rates were 81% (95% CI: 79–83%) ITT, and 84% (82–86%) PP with PCA, and 81% (78–83%) ITT and 84% (82–86%) PP with PCN; the odds ratio for the effect of PCA vs. PCN was 1 (0.83–1.22) on an ITT, and 0.98 (0.8–1.2) on a PP basis. Subanalysis showed that mean H. pylori eradication efficacy with PC(250 b.d.)A was 81% (78–85%) ITT, vs. 86% (83–89%) with PC(250 b.d.)N. The odds ratio for this comparison was 0.68 (0.48–0.98). Finally, when comparing PC(500 b.d.)A against PC(250 b.d.)N ITT cure rates were 77% (74–80%), and 75% (72–78%) with an odds ratio of 1.18 (0.93–1.5). Conclusion: Overall, one‐week combination regimens of PCA and PCN present similar H. pylori eradication efficacy. Nevertheless, the PCN regimen obtains significantly better results when using low doses of C (250 mg b.d.).

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Ulcer Disease andHelicobacter Pylori

Chiba¹

2004

Evidence‐based Gastroenterology and Hepatology

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Incidence of duodenal ulcer healing after 1 week of proton pump inhibitor triple therapy for eradication of Helicobacter pylori

Abstract: The four 1-week treatment regimens were equally effective in healing H. pylori associated duodenal ulcer disease.

Cited by 23 publications

References 14 publications

Duodenal ulcer healing with 1‐week eradication triple therapy followed, or not, by anti‐secretory treatment: a multicentre double‐blind placebo‐controlled trial

Duodenal ulcer healing with 1‐week eradication triple therapy followed, or not, by anti‐secretory treatment: a multicentre double‐blind placebo‐controlled trial

Proton pump inhibitor, clarithromycin and either amoxycillin or nitroimidazole: a meta‐analysis of eradication of Helicobacter pylori

Ulcer Disease andHelicobacter Pylori

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