title: Randomized trial comparing rabeprazole- versus lansoprazole-based Helicobacter pylori eradication regimens.
abstract: Different types of proton pump inhibitor (PPI)-based triple therapies could result in different Helicobacter pylori eradication rates. This study aimed to compare the efficacy and safety of rabeprazole- and lansoprazole-based triple therapies in primary treatment of H. pylori infection. From September 2005 to July 2008, 426 H. pylori-infected patients were randomly assigned to receive a 7-day eradication therapy with either rabeprazole 20mgbid (RAC group, n=222) or lansoprazole 30mgbid (LAC group, n=228) in combination with amoxicillin 1gbid and clarithromycin 500mgbid. The patients received follow-up esophagogastroduodenoscopy (EGD) and/or (13)C-urea breath test 12-16 weeks later to define H. pylori status. Their personal and medical history, compliance and side effects were obtained by using a standardized questionnaire. Intention-to-treat analysis revealed that the eradication rate was 87.84% in the RAC group and 85.96% in the LAC group (p=0.56). All patients returned for assessment of compliance (100% in the LAC group vs. 99.50% in the RAC group; p=0.32) and adverse events (7.20% in the RAC group vs. 5.70% in the LAC group, p=0.51). Univariate analysis suggested that patients with nonsteroid anti-inflammatory agent (NSAID) use had lower eradication rates than those without (76.71% vs. 88.74%; p=0.006). Our results showed that efficacy and safety were similar in rabeprazole- and lansoprazole-based primary therapies. The influence of NSAID usage on H. pylori eradication needs to be further investigated.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Meng-Kwan
authors.initials: MK
authors.lastname: Liu
authors.forename: I-Chen
authors.initials: IC
authors.lastname: Wu
authors.forename: Chien-Yu
authors.initials: CY
authors.lastname: Lu
authors.forename: Chao-Hung
authors.initials: CH
authors.lastname: Kuo
authors.forename: Fang-Jung
authors.initials: FJ
authors.lastname: Yu
authors.forename: Chung-Jung
authors.initials: CJ
authors.lastname: Liu
authors.forename: Ping-I
authors.initials: PI
authors.lastname: Hsu
authors.forename: Wen-Hung
authors.initials: WH
authors.lastname: Hsu
authors.forename: Yu-Chung
authors.initials: YC
authors.lastname: Su
authors.forename: Angela
authors.initials: A
authors.lastname: Chen
authors.forename: Deng-Chyang
authors.initials: DC
authors.lastname: Wu
authors.forename: Fu-Chen
authors.initials: FC
authors.lastname: Kuo
authors.forename: Jyh-Jou
authors.initials: JJ
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D001944:Breath Tests; D017291:Clarithromycin / Q000627:therapeutic use; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004384:Duodenoscopy; D005260:Female; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D016480:Helicobacter pylori / Q000187:drug effects / Q000254:growth & development; D006801:Humans; D064747:Lansoprazole / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D064750:Rabeprazole / Q000627:therapeutic use*
chemical_list: D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors; D064747:Lansoprazole; D064750:Rabeprazole; D000658:Amoxicillin; D017291:Clarithromycin