Improvement in symptoms after H2-receptor antagonist-based therapy for eradication of H pylori infection.
OBJECTIVE
To investigate the therapeutic effects of triple therapy combining lafutidine with clarithromycin and amoxicillin on H pylori infection and the resolution of gastroesophageal symptoms after eradication.


METHODS
We conducted a randomized, multicenter, open-label controlled trial to compare the effectiveness of a triple therapy of lafutidine, clarithromycin, and amoxicillin (lafutidine group) with that of a triple therapy of lansoprazole, clarithromycin, and amoxicillin (lansoprazole group) in patients with H pylori infection. The study group comprised 22 patients with gastric ulcers and 18 patients with duodenal ulcers who had H pylori infection.


RESULTS
H pylori eradication rates were similar in the lafutidine group (14/20, 70%) and the lansoprazole group (14/20, 70%). Gastroesophageal reflux and abdominal symptoms improved after eradication therapy in both groups, whereas abdominal discomfort, diarrhea, and constipation were unchanged. H pylori status had no apparent effect on improvement of gastroesophageal reflux or abdominal symptoms after treatment. Adverse events were similar in both groups.


CONCLUSIONS
The triple therapy including lafutidine is equivalent to triple therapy including lansoprazole in terms of H pylori eradication rates and improvement in gastroesophageal reflux and abdominal symptoms. These results are attributed to the fact that lafutidine has strong, continuous antisecretory activity, unaffected by CYP2C19 polymorphisms.
Hagiwara
Takeshi
T
Department of Gastroenterology, Sapporo-Kosei General Hospital, Sapporo, Hokkaido 060-4876, Japan.
Kato
Mototsugu
M
Anbo
Tomonori
T
Imamura
Akimichi
A
Suga
Toshihiro
T
Uchida
Takumi
T
Fujinaga
Akira
A
Nakagawa
Manabu
M
Nakagawa
Soichi
S
Shimizu
Yuichi
Y
Yamamoto
Jyunji
J
Takeda
Hiroshi
H
Asaka
Masahiro
M
D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000494:pharmacology / Q000627:therapeutic use; D000081:Acetamides / Q000494:pharmacology / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000494:pharmacology / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000494:pharmacology / Q000627:therapeutic use; D017291:Clarithromycin / Q000494:pharmacology / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects*; D006635:Histamine H2 Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D064747:Lansoprazole; D008297:Male; D008875:Middle Aged; D010880:Piperidines / Q000494:pharmacology / Q000627:therapeutic use*; D011725:Pyridines / Q000494:pharmacology / Q000627:therapeutic use*
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000081:Acetamides; D000890:Anti-Infective Agents; D006635:Histamine H2 Antagonists; D010880:Piperidines; D011725:Pyridines; D064747:Lansoprazole; C076948:lafutidine; D000658:Amoxicillin; D017291:Clarithromycin