Once-daily, low-cost, highly effective Helicobacter pylori treatment to family members of gastric cancer patients.
BACKGROUND
Helicobacter pylori eradication in family members of gastric cancer patients is now widely accepted, although problems related to costs and compliance persist.


OBJECTIVE
To compare the efficacy, tolerability and long-term re-infection rates of two once-daily regimens for the eradication of H. pylori in family members of gastric cancer patients.


METHODS
106 first-degree family members of gastric cancer patients were recruited and submitted to the 13C-urea breath test (UBT) to detect H. pylori. If positive, they were randomly allocated to receive a combination of lanzoprazole 30 mg, clarithromycin OD (extended-release formulation) 500 mg and furazolidone 400 mg, once daily, in the morning, for 7 days (Group A) or the same regimen with only 200 mg furazolidone (Group B). Eradication was confirmed by urea breath test performed 6 weeks after treatment. 13C-urea breath test was repeated at 944 (784-1258) days after treatment in successfully treated participants to look for re-infection.


RESULTS
Twenty-five participants were H. pylori negative and two H. pylori-positive individuals refused to sign the informed consent and were excluded. Therefore, 79 participants were studied. Forty participants were allocated to Group A and 39 to Group B. All participants completed treatment. Adverse effects, mostly mild, were observed in 18% of Group A and 18% of Group B (N.S.). The intention-to-treat eradication rate was 87.5% in Group A and 61.5% in Group B (P = 0.006). The mean annual re-infection rate was 3%.


CONCLUSIONS
The combination of lanzoprazole 30 mg, one tablet of clarithromycin OD (extended release formulation) 500 mg and furazolidone 400 mg, once daily for 7 days, constitutes an inexpensive, safe and effective alternative for anti-H. pylori therapy in family members of gastric cancer patients.
Coelho
L G V
LG
Instituto Alfa de Gastroenterologia, Universidade Federal Minas Gerais, Rua dos Otoni 705/601, Belo Horizonte MG, 30150-270, Brazil. lcoelho@gold.com.br
Martins
G M
GM
Passos
M C F
MC
Bueno
M L
ML
Sanches
B S F
BS
Lopes
L G
LG
Miranda
C H D
CH
Castro
L P
LP
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage; D017291:Clarithromycin / Q000008:administration & dosage; D003692:Delayed-Action Preparations; D004359:Drug Therapy, Combination; D005192:Family Health; D005260:Female; D005500:Follow-Up Studies; D005664:Furazolidone / Q000008:administration & dosage; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D064747:Lansoprazole; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000008:administration & dosage / Q000031:analogs & derivatives; D013274:Stomach Neoplasms; D013607:Tablets; D016896:Treatment Outcome
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D003692:Delayed-Action Preparations; D013607:Tablets; D064747:Lansoprazole; D005664:Furazolidone; D017291:Clarithromycin; D009853:Omeprazole