title: Efficacy of low-dose proton pump inhibitor (PPI) in the eradication of Helicobacter pylori following combination PPI/AC therapy in Japan.
abstract: OBJECTIVE
  In Japan, eradication regimens consisting of a proton pump inhibitor (PPI) + amoxicillin (AMPC) + clarithromycin (CAM) (PPI/AC) for 1 week have been conducted. In the present study, we assessed the eradication rates following treatment with low doses of various PPIs.
  
  
  METHODS
  135 patients were divided randomly into one of three 7-day regimens: (i) omeprazole (OPZ) 20 mg/day + AMPC 1500 mg/day + CAM 600 mg/day (OAC); (ii) lansoprazole (LPZ) 30 mg + AMPC 1500 mg/day + CAM 600 mg/day (LAC); and (iii) rabeprazole (RPZ) 10mg/day + AMPC 1500 mg/ day + CAM 600 mg/day (RAC). The genetic polymorphism of CYP2C19 was also examined.
  
  
  RESULTS
  The eradication rates according to the treatment regimen were as follows: 69.9% (31/45) for OAC, 62.2% (28/45) for LAC, and 71.1% (32/45) for RPZ. No significant differences were found among the regimens. Moreover, eradication rates, according to CYP2C19 phenotype (homozygous extensive metabolizer (EM), heterozygous EM, and poor metabolizer) were: 68.6% (35/51), 77.4% (41/53), and 82.4% (14/17), respectively.
  
  
  CONCLUSIONS
  In PPI/AC therapy, the eradication rate for each low-dose PPI was 60-70%, which is low. Based on previous reports, it is considered that doses greater than 40 mg/day OPZ, 60 mg/day LPZ, and 20 mg/day RPZ are required.
authors.affiliation: Endoscopy Center, Tokyo Medical University Hospital, Japan. t-kawai@tokyo-med.ac.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Kawai
authors.forename: Kohei
authors.initials: K
authors.lastname: Kawakami
authors.forename: Kataoka
authors.initials: K
authors.lastname: Mikinori
authors.forename: Kazuo
authors.initials: K
authors.lastname: Takei
authors.forename: Takao
authors.initials: T
authors.lastname: Itoi
authors.forename: Fuminori
authors.initials: F
authors.lastname: Moriyasu
authors.forename: Yuu
authors.initials: Y
authors.lastname: Takagi
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Aoki
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Watanebe
authors.forename: Yuushuke
authors.initials: Y
authors.lastname: Matsumoto
authors.forename: Emiko
authors.initials: E
authors.lastname: Rimbara
authors.forename: Norihisa
authors.initials: N
authors.lastname: Noguchi
authors.forename: Masanori
authors.initials: M
authors.lastname: Sasatsu
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000008:administration & dosage*; D000897:Anti-Ulcer Agents / Q000008:administration & dosage*; D001189:Aryl Hydrocarbon Hydroxylases / Q000235:genetics; D017291:Clarithromycin / Q000008:administration & dosage*; D065731:Cytochrome P-450 CYP2C19; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000235:genetics; D016480:Helicobacter pylori; D006801:Humans; D064747:Lansoprazole; D008297:Male; D008875:Middle Aged; D006899:Mixed Function Oxygenases / Q000235:genetics; D009853:Omeprazole / Q000008:administration & dosage*; D010641:Phenotype; D011110:Polymorphism, Genetic / Q000235:genetics; D054328:Proton Pump Inhibitors; D064750:Rabeprazole; D019233:Retreatment; D013272:Stomach Diseases / Q000188:drug therapy* / Q000235:genetics; D016896:Treatment Outcome
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors; D064747:Lansoprazole; D064750:Rabeprazole; D000658:Amoxicillin; D006899:Mixed Function Oxygenases; D001189:Aryl Hydrocarbon Hydroxylases; C045793:CYP2C19 protein, human; D065731:Cytochrome P-450 CYP2C19; D017291:Clarithromycin; D009853:Omeprazole