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[Effects of different triple therapies on duodenal ulcer-associated Helicobacter pylori infection and a one-year follow-up study].
Zhonghua Yi Xue Za Zhi. 2004 Jul 17; 84(14):1161-5.ZY

Abstract

OBJECTIVE

To evaluate the effects of different triple therapies on healing of duodenal ulcer associated with Helicobacter pylori (Hp) infection; Hp eradication; and ulcer recurrence.

METHOD

248 patients with Hp-associated active duodenal ulcer confirmed by endoscopy, 193 males and 55 females, were randomized to receive OAC(250): omeprazole (0.20 mg bid) + amoxicillin (1000 mg bid) + clarithromycin (250 mg bid), for 1 week (group A1) or 2 weeks (group A2); OAC(500): omeprazole (0.20 mg bid) + amoxicillin (1000 mg bid) + clarithromycin (500 mg bid), for 1 week (group B1) or 2 weeks (group B2); or OAM: omeprazole (0.20 mg bid) + amoxicillin (1000 mg bid) + metronidazole (400 mg bid), for 1 week (group C1) or 2 weeks (group C2) respectively. Endoscopy and biopsy were performed at least 4 weeks after the end of therapy to unde5rgo histological examination. Rapid urease test was performed. Endoscopy and histological examination and rapid urease test were performed twice again on the patients with the ulcer healed 6 months and one year after so as to observe the recurrence rate.

RESULTS

By protocol analysis the ulcer healing rates of the groups A1, A2, B1, B2, C1, and C2 were 93.3% (42/45), 92.7% (38/41); 89.2% (33/37), 94.9% (37/39); 88.4% (38/43), and 93.0% (40/43) respectively without a significant difference between any 2 groups (all P > 0.05); and the Hp eradication rates of the groups A1, A2, B1, B2, C1, and C2 were 86.7% (39/45), 90.2% (37/41); 89.2% (33/37), 92.3% (36/39); 67.4% (29/43), and 86.0% (37/43) respectively. The Hp eradication rate of OAM for 1-week group was significantly lower than the OAC(250)/OAC(250) for 1-week groups (all P < 0.05), and the Hp eradication rate of OAM for 1-week group was significantly lower than that of the OAM for 2-weeks group (P < 0.05). The 6-month follow-up showed an ulcer recurrence rate of 41.2% (7/17) for the patients without successful Hp eradication and an ulcer recurrence rate of 0% (0/130) for the patients with successful Hp eradication (P < 0.001). One-year follow-up showed an ulcer recurrence rate of 58.9% (10/17) for the patients without successful Hp eradication and an ulcer recurrence rate of 2.3% (3/130) for the patients with successful Hp eradication (P < 0.001).

CONCLUSION

Omeprazole-based triple therapy with clarithromycin and amoxicillin for 1-week is the best regimen for the treatment of patient with Hp positive duodenal ulcer disease. Omeprazole-based triple therapies have achieved the highest eradication rates and lowest ulcer recurrence rates.

Authors

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study
Randomized Controlled Trial

Language

chi

PubMed ID

15387976

Citation

Multiple Center Study Group In Beijing Area, China. "[Effects of Different Triple Therapies On Duodenal Ulcer-associated Helicobacter Pylori Infection and a One-year Follow-up Study]." Zhonghua Yi Xue Za Zhi, vol. 84, no. 14, 2004, pp. 1161-5.
Multiple Center Study Group In Beijing Area, China. [Effects of different triple therapies on duodenal ulcer-associated Helicobacter pylori infection and a one-year follow-up study]. Zhonghua Yi Xue Za Zhi. 2004;84(14):1161-5.
Multiple Center Study Group In Beijing Area, China. (2004). [Effects of different triple therapies on duodenal ulcer-associated Helicobacter pylori infection and a one-year follow-up study]. Zhonghua Yi Xue Za Zhi, 84(14), 1161-5.
Multiple Center Study Group In Beijing Area, China. [Effects of Different Triple Therapies On Duodenal Ulcer-associated Helicobacter Pylori Infection and a One-year Follow-up Study]. Zhonghua Yi Xue Za Zhi. 2004 Jul 17;84(14):1161-5. PubMed PMID: 15387976.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Effects of different triple therapies on duodenal ulcer-associated Helicobacter pylori infection and a one-year follow-up study]. A1 - ,, PY - 2004/9/25/pubmed PY - 2005/1/29/medline PY - 2004/9/25/entrez SP - 1161 EP - 5 JF - Zhonghua yi xue za zhi JO - Zhonghua Yi Xue Za Zhi VL - 84 IS - 14 N2 - OBJECTIVE: To evaluate the effects of different triple therapies on healing of duodenal ulcer associated with Helicobacter pylori (Hp) infection; Hp eradication; and ulcer recurrence. METHOD: 248 patients with Hp-associated active duodenal ulcer confirmed by endoscopy, 193 males and 55 females, were randomized to receive OAC(250): omeprazole (0.20 mg bid) + amoxicillin (1000 mg bid) + clarithromycin (250 mg bid), for 1 week (group A1) or 2 weeks (group A2); OAC(500): omeprazole (0.20 mg bid) + amoxicillin (1000 mg bid) + clarithromycin (500 mg bid), for 1 week (group B1) or 2 weeks (group B2); or OAM: omeprazole (0.20 mg bid) + amoxicillin (1000 mg bid) + metronidazole (400 mg bid), for 1 week (group C1) or 2 weeks (group C2) respectively. Endoscopy and biopsy were performed at least 4 weeks after the end of therapy to unde5rgo histological examination. Rapid urease test was performed. Endoscopy and histological examination and rapid urease test were performed twice again on the patients with the ulcer healed 6 months and one year after so as to observe the recurrence rate. RESULTS: By protocol analysis the ulcer healing rates of the groups A1, A2, B1, B2, C1, and C2 were 93.3% (42/45), 92.7% (38/41); 89.2% (33/37), 94.9% (37/39); 88.4% (38/43), and 93.0% (40/43) respectively without a significant difference between any 2 groups (all P > 0.05); and the Hp eradication rates of the groups A1, A2, B1, B2, C1, and C2 were 86.7% (39/45), 90.2% (37/41); 89.2% (33/37), 92.3% (36/39); 67.4% (29/43), and 86.0% (37/43) respectively. The Hp eradication rate of OAM for 1-week group was significantly lower than the OAC(250)/OAC(250) for 1-week groups (all P < 0.05), and the Hp eradication rate of OAM for 1-week group was significantly lower than that of the OAM for 2-weeks group (P < 0.05). The 6-month follow-up showed an ulcer recurrence rate of 41.2% (7/17) for the patients without successful Hp eradication and an ulcer recurrence rate of 0% (0/130) for the patients with successful Hp eradication (P < 0.001). One-year follow-up showed an ulcer recurrence rate of 58.9% (10/17) for the patients without successful Hp eradication and an ulcer recurrence rate of 2.3% (3/130) for the patients with successful Hp eradication (P < 0.001). CONCLUSION: Omeprazole-based triple therapy with clarithromycin and amoxicillin for 1-week is the best regimen for the treatment of patient with Hp positive duodenal ulcer disease. Omeprazole-based triple therapies have achieved the highest eradication rates and lowest ulcer recurrence rates. SN - 0376-2491 UR - https://www.unboundmedicine.com/medline/citation/15387976/[Effects_of_different_triple_therapies_on_duodenal_ulcer_associated_Helicobacter_pylori_infection_and_a_one_year_follow_up_study]_ L2 - http://journal.yiigle.com/LinkIn.do?linkin_type=pubmed&amp;issn=0376-2491&amp;year=2004&amp;vol=84&amp;issue=14&amp;fpage=1161 DB - PRIME DP - Unbound Medicine ER -