One-week triple therapy with esomeprazole provides effective eradication of Helicobacter pylori in duodenal ulcer disease.
BACKGROUND
Esomeprazole is the first proton pump inhibitor to be developed as an optical isomer for the treatment of acid-related diseases.


METHODS
Four hundred and forty eight duodenal ulcer patients with Helicobacter pylori infection, confirmed by 13C-urea breath test (UBT), and no current ulcer, were randomised to double-blind treatment with esomeprazole 20 mg twice daily (b.d.) (n=224) or omeprazole 20 mg b.d. (n=224), in combination with amoxicillin 1 g b.d. and clarithromycin 500 mg b.d. for 1 week (EAC and OAC, respectively). A negative UBT at both 4 and 8 weeks after completing therapy indicated successful H. pylori eradication.


RESULTS
Intention-to-treat (ITT) analysis comprised 400 patients (EAC, n=204; OAC, n=196) and per protocol (PP) analysis 377 patients (EAC, n=192; OAC, n=185). Eradication rates (95% confidence intervals) for ITT and PP populations were: EAC, 90% (85-94%) and 91% (86-94%); OAC, 88% (82-92%) and 91% (86-95%). Between-group differences in eradication rates were not statistically significant. Both regimens were well tolerated, with an adverse event profile and frequency typical of proton pump inhibitor plus antibiotic combination therapy.


CONCLUSIONS
Esomeprazole-based triple therapy for 1 week is highly effective in eradicating H. pylori infection in duodenal ulcer disease, offers comparable efficacy to omeprazole-based therapy, and is well tolerated.
Veldhuyzen Van Zanten
S
S
Queen Elizabeth II Health Science Centre, Halifax, Nova Scotia, Canada.
Lauritsen
K
K
Delchier
J C
JC
Labenz
J
J
De Argila
C M
CM
Lind
T
T
Treichel
H C
HC
Stubberöd
A
A
Cockeram
A
A
Hasselgren
G
G
Göthe
L
L
Wrangstadh
M
M
Sinclair
P
P
D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000008:administration & dosage; D017291:Clarithromycin / Q000008:administration & dosage; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004381:Duodenal Ulcer / Q000188:drug therapy*; D004791:Enzyme Inhibitors / Q000008:administration & dosage*; D064098:Esomeprazole; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000008:administration & dosage*; D013237:Stereoisomerism
D004791:Enzyme Inhibitors; D000658:Amoxicillin; D017291:Clarithromycin; D009853:Omeprazole; D064098:Esomeprazole