Comparison of cetraxate-based and pantoprazole-based triple therapies in the treatment of Helicobacter pylori infection.
BACKGROUND
Recent studies suggest that cetraxate possesses anti-Helicobacter pylori (H. pylori) activity. We therefore conducted this pilot study to investigate the efficacy of a cetraxate-based triple therapy and to compare the regimen with proton pump inhibitor-based triple therapy.


METHODS
From April 2001 to January 2002, a total of 58 H. pylori-infected patients were randomly assigned to 1 of 2 regimens for 1 week: cetraxate plus clarithromycin and amoxicillin (CCA group) or pantoprazole plus clarithromycin and amoxicillin (PCA group). Follow-up endoscopy was performed at 8 weeks after the end of treatment to assess the treatment response.


RESULTS
Intention-to-treat analysis showed that the eradication rates of the CCA group (n = 27) and PCA group (n = 31) were 70.4% and 93.5%, respectively. The CCA group had a significantly lower eradication rate than the PCA group (p = 0.03). Per-protocol analysis also showed similar results (69.2% vs. 96.7%, p = 0.01). However, the frequency of adverse events in the CCA group was lower than that of the PCA group (3.7% vs. 25.8%, p = 0.03). Univariate analysis showed that the eradication rate was significantly related to proton pump inhibitor therapy (93.5% vs. 70.4%, p = 0.03 ) and smoking habit (66.7 % vs. 88.4%, p = 0.05), but multivariate analysis disclosed that proton pump inhibitor therapy was the only independent factor predicting treatment success (p < 0.05).


CONCLUSIONS
Cetraxate-based triple therapy is less effective than pantoprazole-based triple therapy in the treatment of H. pylori infection. However, the former has a lower frequency of adverse effects than the latter.
Wu
Chung-Jen
CJ
Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, National Yang-Ming University, Kaohsiung, Taiwan, ROC.
Hsu
Ping-I
PI
Lo
Gin-Ho
GH
Lo
Ching-Chu
CC
Lin
Chiun-Ku
CK
Shie
Chang-Bih
CB
Peng
Nan-Jing
NJ
Tseng
Hui-Hwa
HH
Jou
Huei-Shu
HS
Tsai
Pei-Min
PM
Chen
Angela
A
Chen
Jin-Liang
JL
Lai
Kwok-Hung
KH
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000009:adverse effects / Q000627:therapeutic use*; D017291:Clarithromycin / Q000627:therapeutic use; D004244:Dizziness / Q000139:chemically induced; D004359:Drug Therapy, Combination; D020776:Endoscopes, Gastrointestinal; D005076:Exanthema / Q000139:chemically induced; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009853:Omeprazole / Q000031:analogs & derivatives; D000077402:Pantoprazole; D010865:Pilot Projects; D011446:Prospective Studies; D013454:Sulfoxides / Q000009:adverse effects / Q000627:therapeutic use*; D014148:Tranexamic Acid / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D016896:Treatment Outcome
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D001562:Benzimidazoles; D013454:Sulfoxides; C000665:cetraxate; D014148:Tranexamic Acid; D000658:Amoxicillin; D000077402:Pantoprazole; D017291:Clarithromycin; D009853:Omeprazole