A pilot study to evaluate a new combination therapy for gastric ulcer: Helicobacter pylori eradication therapy followed by gastroprotective treatment with rebamipide.
OBJECTIVE
Controversies remain over the need for antiulcer treatment following 1-week eradication triple therapy for Helicobacter pylori-positive peptic ulcers. The usefulness of combination therapy for gastric ulcers in Japanese patients, which consists of H. pylori eradication followed by gastroprotective therapy with rebamipide, was therefore evaluated.


METHODS
The study was conducted in 52 H. pylori-positive patients with an endoscopically-proven open gastric ulcer. All patients received 1-week triple therapy (lansoprazole, amoxicillin and clarithromycin) followed by 7-week rebamipide therapy. After completion of the combination therapy, all patients underwent evaluation of ulcer healing by endoscopy, gastric ulcer symptoms and H. pylori eradication by rapid urease test and (13)C-urea breath test.


RESULTS
The ulcer healing rates were 85.7% (36/42) at 8 weeks, 83.3% (30/36) in eradicated patients and 100% (6/6) in non-eradicated patients. The overall gastrointestinal symptom-free rate improved from 19.0% at baseline to 88.1% at 8 weeks. H. pylori was effectively eradicated in 85.7% (36/42) of patients.


CONCLUSIONS
The results suggested that the combination therapy for open gastric ulcer was safe, well-tolerated and effective. However, data from a double-blind placebo-controlled study is necessary to confirm these findings.
Terano
Akira
A
Department of Gastroenterology, Dokkyo University School of Medicine, Japan. akterano@dokkyomed.ac.jp
Arakawa
Tetsuo
T
Sugiyama
Toshiro
T
Yoshikawa
Toshikazu
T
Haruma
Ken
K
Asaka
Masahiro
M
Shimosegawa
Tooru
T
Sakaki
Nobuhiro
N
Ishii
Hiromasa
H
Sakamoto
Choitsu
C
Takahashi
Shin-Ichi
S
Kinoshita
Yoshikazu
Y
Fujioka
Toshio
T
Kobayashi
Kenzo
K
D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000409:Alanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000658:Amoxicillin / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D001944:Breath Tests; D017291:Clarithromycin / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D007564:Japan; D064747:Lansoprazole; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D015363:Quinolones / Q000627:therapeutic use*; D013276:Stomach Ulcer / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D016896:Treatment Outcome
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000890:Anti-Infective Agents; D000897:Anti-Ulcer Agents; D015363:Quinolones; D064747:Lansoprazole; D000658:Amoxicillin; D017291:Clarithromycin; C052785:rebamipide; D000409:Alanine