Efficacy of two different Helicobacter pylori eradication regimens in patients with type 2 diabetes and the effect of Helicobacter pylori eradication on dyspeptic symptoms in patients with diabetes: a randomized controlled study.
BACKGROUND
The eradication rate of Helicobacter pylori with a standard triple regimen has been reported as being lower in patients with type 2 diabetes mellitus (DM) than in those without DM. The aim of this study was to evaluate the efficacy and tolerability of 2 different H. pylori eradication regimens in patients with type 2 DM.


METHODS
Ninety-eight consecutive type 2 DM and 116 nondiabetic age- and sex-matched patients were enrolled in this study. Patients were randomized to receive either pantoprazole, clarithromycin, and amoxicillin (PCA) for 14 days or ranitidine-bismuth citrate, clarithromycin, and amoxicillin (RCA) for 14 days as the eradication regimen. H. pylori eradication was assessed using C14-urea breath test 6 weeks after the end of therapy.


RESULTS
The H. pylori eradication rate with PCA regimen in patients with DM with both intention-to-treat (ITT) and per protocol (PP) analysis was 24/49 (48.9% and 62.9%) and in non-DM patients was 44/58 (75.9% and 86.7%) with ITT and 44/57 (77.2% and 88.2%) with PP analysis (P < 0.05). The H. pylori eradication rates with RCA regimen in patients with DM were 22/49 (45.9% and 59.8%) with ITT and 22/48 (45.8% and 59.9%) with PP analysis and in non-DM patients were 44/58 (75.9% and 86.7%) with ITT and 44/56 (78.6% and 89.3%) with PP analysis.


CONCLUSIONS
These data suggest that the eradication rate of H. pylori with PCA or RCA treatment is lower in patients with type 2 diabetes than in nondiabetics and that successful eradication could decrease dyspeptic symptoms.
Demir
Mehmet
M
Department of Gastroenterology (md, hsg, nao), Baskent University Faculty of Medicine, Konya, Turkey.
Gokturk
Huseyin Savas
HS
Ozturk
Nevin Akcaer
NA
Serin
Ender
E
Yilmaz
Ugur
U
D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000008:administration & dosage; D000328:Adult; D000658:Amoxicillin / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000897:Anti-Ulcer Agents / Q000008:administration & dosage; D001729:Bismuth / Q000008:administration & dosage; D017291:Clarithromycin / Q000008:administration & dosage; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D004359:Drug Therapy, Combination; D004415:Dyspepsia / Q000150:complications* / Q000188:drug therapy*; D005260:Female; D016481:Helicobacter Infections / Q000150:complications* / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077402:Pantoprazole; D011899:Ranitidine / Q000008:administration & dosage / Q000031:analogs & derivatives
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; C073340:ranitidine bismuth citrate; D000658:Amoxicillin; D011899:Ranitidine; D000077402:Pantoprazole; D017291:Clarithromycin; D001729:Bismuth