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

Abstract

Background/Aim Ecabet sodium has an anti-H. pylori effect. We assessed the efficacy of ecabet sodium in the rescue therapy for the eradication of H. pylori. Methods A total of 74 patients with failed eradication of H. pylori after triple therapy with lansoprazole 30 mg bid, amoxicillin 750 mg bid and clarithromycin 200 mg bid were enrolled. They were randomly assigned to the three treatment groups as follows: LAC, lansoprazole 30 mg + amoxicillin 750 mg + clarithromycin 200 mg bid for 1 week; LAC2E, lansoprazole 30 mg bid + amoxicillin 750 mg bid + clarithromycin 200 mg bid + ecabet sodium 2 g bid for 1 week; and LA2E, lansoprazole 30 mg bid + amoxicillin 750 mg bid + ecabet sodium 2 g bid for 2 weeks. Eradication of H. pylori was assessed by the 13C-urea breath test after treatment. Results Eradication rates in intention-to-treat and per-protocol analyses were 20.0% (95% CI: 6.8-40.7) and 20.0% (6.8-40.7) with LAC, respectively, and 16.0% (4.5-36.1) and 17.4% (5.0-38.8) with LAC2E. In contrast, respective rates with LA2E were 75% (53.3-90.2) and 85.7% (63.7-97.0), which were significantly higher than those with LAC (p<0.001 for both ITT and PP) and LAC2E (p<0.001 for both ITT and PP). Conclusion Triple therapy with ecabet sodium, lansoprazole and amoxicillin for 2 weeks was effective as the rescue therapy after failure of the standard clarithromycin-based regimen.

Systematic review: Would susceptibility‐guided treatment achieve acceptable cure rates for second‐line Helicobacter pylori therapy as currently practiced?

“…Studies reporting duplicate data were excluded. After careful evaluation, 36 studies (including 3466 patients) were found to perform antibiotic susceptibility determinations and were included in the systematic review. Of these 36 articles, 24 reported cure rates according to antibiotic resistances/susceptibilities, including 37 arms of treatment.…”

“…Among these patients, 2890 (83.4%) underwent endoscopy. In 16 of 36 articles, 19,23,24,[26][27][28][29]31,[34][35][36]39,[48][49][50] endoscopy was an inclusion criterion and was performed in all patients; therefore, the rate of acceptance of the procedure could not be evaluated. Nine additional articles performed endoscopy in all patients but did not state whether the procedure was an inclusion criteria or whether patients who rejected endoscopy had been excluded.…”

Helicobacter pylori infection: A recent approach to diagnosis and management

“…The study demonstrated eradication rates of 75% and 85.7% according to ITT and PP analyses, respectively [72]. The anti-HP effect of ecabet sodium has beneficial effects and can be an option for rescue therapy in standard clarithromycin-based triple therapy failure cases.…”

Efficacy and Safety of Ecabet Sodium as an Adjuvant Therapy for Helicobacter pylori Eradication: A Systematic Review and Meta‐Analysis

“…Of these articles, 18 relevant articles were selected and reviewed by two independent authors (W‐YH and W‐B). We further excluded another five unrelated articles, one article with an inappropriate drug regimen , one article describing the use of triple therapy as a rescue regimen for H. pylori infection , one article that did not include an eradication rate , one article with ambiguous H. pylori diagnosis methods , and one article that was not an RCT . Finally, 13 studies were found to meet the inclusion criteria and thus included for the further analysis (Fig.…”