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Effect of lactoferrin supplementation on the effectiveness and tolerability of a 7-day quadruple therapy after failure of a first attempt to cure Helicobacter pylori infection.

Abstract

BACKGROUND

Up to 35% of H. pylori-positive patients remain infected after a first eradication attempt. Lactoferrin, a natural anti-bacterial glycoprotein, seems a promising tool in treating H. pylori infection, but it has never been used in second-line treatment.

MATERIAL/METHODS

A prospective, randomized study was conducted on 70 consecutive patients with persistent H. pylori infection after failure of the first standard treatment schedule. All patients were randomly treated with ranitidine bismuth citrate (RBC, 400 mg b.d.), esomeprazole (40 mg/day), amoxycillin (1 g t.d), and tinidazole (500 mg b.d.) without (group A) or with (group B) supplementation of bovine lactoferrin (200 mg b.d). One month after conclusion of therapy, endoscopy was performed in those patients for whom the examination was clinically relevant. The remaining patients were checked by 13C-urea breath test.

RESULTS

Sixty-seven patients were fully compliant and completed the study (33, i.e. 94.28%, in group A and 34, 97.14%, in group B). One group A patient (2.85%) was excluded for protocol violation and one group B patient (2.85%) was lost to follow-up. H. pylori eradication was obtained in 31/33 (on intention-to-treat: 88.57%, 95%CI: 87-99%) group A patients and in 33/34 (on intention-to-treat: 94.28%, 95%CI: 86-100%) group B patients (p=ns). 16/68 patients (23.53%) experienced side effects (29.41% in group A and 17.64% in group B, p= 0.05).

CONCLUSIONS

Lactoferrin supplementation was found effective in reducing side-effect incidence. Moreover, it seems capable of achieving a slight (and not statistically significant) improvement in eradicating H. pylori when used in second-line treatment.

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  • Authors+Show Affiliations

    ,

    Digestive Endoscopy Unit, "Lorenzo Bonomo" Hospital, Andria (BA), Italy. antotursi@tiscali.it

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    Source

    MeSH

    Adult
    Aged
    Amoxicillin
    Anti-Bacterial Agents
    Bismuth
    Breath Tests
    Endoscopy, Gastrointestinal
    Esomeprazole
    Female
    Helicobacter Infections
    Helicobacter pylori
    Humans
    Lactoferrin
    Male
    Middle Aged
    Prospective Studies
    Ranitidine
    Tinidazole

    Pub Type(s)

    Comparative Study
    Journal Article
    Randomized Controlled Trial

    Language

    eng

    PubMed ID

    17392649

    Citation

    Tursi, Antonio, et al. "Effect of Lactoferrin Supplementation On the Effectiveness and Tolerability of a 7-day Quadruple Therapy After Failure of a First Attempt to Cure Helicobacter Pylori Infection." Medical Science Monitor : International Medical Journal of Experimental and Clinical Research, vol. 13, no. 4, 2007, pp. CR187-90.
    Tursi A, Elisei W, Brandimarte G, et al. Effect of lactoferrin supplementation on the effectiveness and tolerability of a 7-day quadruple therapy after failure of a first attempt to cure Helicobacter pylori infection. Med Sci Monit. 2007;13(4):CR187-90.
    Tursi, A., Elisei, W., Brandimarte, G., Giorgetti, G. M., Modeo, M. E., & Aiello, F. (2007). Effect of lactoferrin supplementation on the effectiveness and tolerability of a 7-day quadruple therapy after failure of a first attempt to cure Helicobacter pylori infection. Medical Science Monitor : International Medical Journal of Experimental and Clinical Research, 13(4), pp. CR187-90.
    Tursi A, et al. Effect of Lactoferrin Supplementation On the Effectiveness and Tolerability of a 7-day Quadruple Therapy After Failure of a First Attempt to Cure Helicobacter Pylori Infection. Med Sci Monit. 2007;13(4):CR187-90. PubMed PMID: 17392649.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Effect of lactoferrin supplementation on the effectiveness and tolerability of a 7-day quadruple therapy after failure of a first attempt to cure Helicobacter pylori infection. AU - Tursi,Antonio, AU - Elisei,Walter, AU - Brandimarte,Giovanni, AU - Giorgetti,Gian Marco, AU - Modeo,Maria Ester, AU - Aiello,Fabio, PY - 2006/08/01/received PY - 2006/09/26/accepted PY - 2007/3/30/pubmed PY - 2008/3/7/medline PY - 2007/3/30/entrez SP - CR187 EP - 90 JF - Medical science monitor : international medical journal of experimental and clinical research JO - Med. Sci. Monit. VL - 13 IS - 4 N2 - BACKGROUND: Up to 35% of H. pylori-positive patients remain infected after a first eradication attempt. Lactoferrin, a natural anti-bacterial glycoprotein, seems a promising tool in treating H. pylori infection, but it has never been used in second-line treatment. MATERIAL/METHODS: A prospective, randomized study was conducted on 70 consecutive patients with persistent H. pylori infection after failure of the first standard treatment schedule. All patients were randomly treated with ranitidine bismuth citrate (RBC, 400 mg b.d.), esomeprazole (40 mg/day), amoxycillin (1 g t.d), and tinidazole (500 mg b.d.) without (group A) or with (group B) supplementation of bovine lactoferrin (200 mg b.d). One month after conclusion of therapy, endoscopy was performed in those patients for whom the examination was clinically relevant. The remaining patients were checked by 13C-urea breath test. RESULTS: Sixty-seven patients were fully compliant and completed the study (33, i.e. 94.28%, in group A and 34, 97.14%, in group B). One group A patient (2.85%) was excluded for protocol violation and one group B patient (2.85%) was lost to follow-up. H. pylori eradication was obtained in 31/33 (on intention-to-treat: 88.57%, 95%CI: 87-99%) group A patients and in 33/34 (on intention-to-treat: 94.28%, 95%CI: 86-100%) group B patients (p=ns). 16/68 patients (23.53%) experienced side effects (29.41% in group A and 17.64% in group B, p= 0.05). CONCLUSIONS: Lactoferrin supplementation was found effective in reducing side-effect incidence. Moreover, it seems capable of achieving a slight (and not statistically significant) improvement in eradicating H. pylori when used in second-line treatment. SN - 1234-1010 UR - https://www.unboundmedicine.com/medline/citation/17392649/Effect_of_lactoferrin_supplementation_on_the_effectiveness_and_tolerability_of_a_7_day_quadruple_therapy_after_failure_of_a_first_attempt_to_cure_Helicobacter_pylori_infection_ L2 - https://www.medscimonit.com/download/index/idArt/481102 DB - PRIME DP - Unbound Medicine ER -