Improvement in symptoms after H2-receptor antagonist-based therapy for eradication of H pylori infection

doi:10.3748/wjg.v13.i28.3836

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

H Pylori

World J Gastroenterol. Jul 28, 2007; 13(28): 3836-3840
Published online Jul 28, 2007. doi: 10.3748/wjg.v13.i28.3836

Improvement in symptoms after H₂-receptor antagonist-based therapy for eradication of H pylori infection

Takeshi Hagiwara, Mototsugu Kato, Tomonori Anbo, Akimichi Imamura, Toshihiro Suga, Takumi Uchida, Akira Fujinaga, Manabu Nakagawa, Soichi Nakagawa, Yuichi Shimizu, Jyunji Yamamoto, Hiroshi Takeda, Masahiro Asaka

Takeshi Hagiwara, Tomonori Anbo, Akimichi Imamura, Toshihiro Suga, Department of Gastroenterology, Sapporo-Kosei General Hospital, Sapporo, Hokkaido 060-4876, Japan

Mototsugu Kato, Manabu Nakagawa, Soichi Nakagawa, Yuichi Shimizu, Division of Endoscopy, Hokkaido University Hospital, Sapporo, Hokkaido 060-4876, Japan

Takumi Uchida, Akira Fujinaga, Department of Internal Medicine, Abashiri-Kosei General Hospital, Abashiri, Japan

Jyunji Yamamoto, Hiroshi Takeda, Masahiro Asaka, Department of Gastroenterology, Graduate School of Medicine Hokkaido University, Sapporo, Hokkaido 060-4876, Japan

Author contributions: All authors contributed equally to the work.

Correspondence to: Dr. Mototsugu Kato, MD, PhD, Division of Endoscopy, Hokkaido University Hospital, Nishi-5, Kita-14, Kita-ku, Sapporo, Hokkaido 060-4876, Japan. m-kato@med.hokudai.ac.jp

Telephone: +81-11-7161161 Fax: +81-11-7067867

Received: August 1, 2006
Revised: August 20, 2006
Accepted: August 22, 2006
Published online: July 28, 2007

Abstract

AIM: 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.

CONCLUSION: 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.

Keywords: H pylori; Gastroesophageal symptoms; Lafutidine; Lansoprazole