Helicobacter pylori and early duodenal ulcer status post-treatment: a review.
BACKGROUND
Data submitted to the FDA were reviewed to analyze the relationship between Helicobacter pylori infection and the incidence of early duodenal ulcers, within 6 weeks, following treatment.


METHODS
Retrospective analyzes were performed on data from three H. pylori development programs submitted to the FDA: ranitidine-bismuth-citrate (RBC), lansoprazole (L) and omeprazole (O). Efficacy assessments for the RBC, L and O programs were made at end of a 4-week treatment period, 4-6 weeks following the end of a 14-day treatment period, and 4 weeks following the end of a 4-week treatment period, respectively.


RESULTS
Overall, there was a 15%, 21% and 23% decrease in the number of patients in the RBC, L and O programs, respectively, with ulcers among H. pylori cleared/eradicated patients post-treatment compared with patients with persistent infection. Among patients who did not have cleared/eradicated H. pylori in the RBC and O programs, where antisecretory agents were continued beyond the antimicrobial treatment period, the number of ulcers was lower in the antisecretory plus antimicrobial subgroups compared with the antimicrobial alone subgroups (37% vs. 46% for RBC and 33% vs. 42% for O). Among patients with cleared/eradicated H. pylori, the number of patients with ulcers in the antimicrobial alone subgroups and antisecretory plus antimicrobial subgroups were similar within each program. Antimicrobials alone had significantly lower rates of ulcers among patients with cleared/eradicated H. pylori as compared with patients without clearance/eradication.


CONCLUSIONS
The early incidence of duodenal ulcers is significantly decreased in patients with H. pylori clearance/eradication.
Meyer
J M
JM
Food and Drug Administration, Division of Special Pathogen and Immunologic Drug Products, Rockville, MD 20850, USA.
Silliman
N P
NP
Dixon
C A
CA
Siepman
N Y
NY
Sugg
J E
JE
Hopkins
R J
RJ
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D001729:Bismuth / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D004381:Duodenal Ulcer / Q000517:prevention & control*; D005500:Follow-Up Studies; D016481:Helicobacter Infections / Q000188:drug therapy*; D006801:Humans; D064747:Lansoprazole; D016017:Odds Ratio; D009853:Omeprazole / Q000031:analogs & derivatives / Q000627:therapeutic use; D011899:Ranitidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D012107:Research Design; D012189:Retrospective Studies; D014481:United States; D014486:United States Food and Drug Administration
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000890:Anti-Infective Agents; D000897:Anti-Ulcer Agents; D064747:Lansoprazole; C073340:ranitidine bismuth citrate; D011899:Ranitidine; D009853:Omeprazole; D001729:Bismuth