H2 -antagonist maintenance therapy versus Helicobacter pylori eradication in patients with chronic duodenal ulcer disease: a prospective study

Autor:	M. Malek, D. Hopwood, B. W. Senior, M. Tavakoli, Andrzej T. Prach, F. E. Murray
Rok vydání:	1998
Předmět:	medicine.medical_specialty Hepatology biology business.industry medicine.medical_treatment Gastroenterology Helicobacter pylori biology.organism_classification H2 antagonist Clinical trial Ranitidine Metronidazole Maintenance therapy Clarithromycin Internal medicine medicine Pharmacology (medical) business Omeprazole medicine.drug
Zdroj:	Alimentary Pharmacology & Therapeutics. 12:873-880
ISSN:	0269-2813
DOI:	10.1046/j.1365-2036.1998.00391.x
Popis:	Background: Few outcome studies directly compare Helicobacter pylori eradication therapy with maintenance H2-antagonist therapy in duodenal ulcer disease. Aim: To examine prospectively the efficacy of H. pylori eradication therapy with ranitidine maintenance therapy over 1 year in patients with confirmed chronic duodenal ulcer. Methods: One hundred and nineteen patients with active H. pylori infection were randomized to receive ranitidine, 150 mg/day initially (58 patients), or omeprazole, 40 mg/day, amoxycillin 2 g/day and metronidazole 1.2 g/day for 14 days, or omeprazole 40 mg/day and clarithromycin 1.5 g/day, for 14 days (if penicillin-allergic). Symptoms were assessed using the Gastro-intestinal System Rating Scale (GSRS) and SF36 quality of life index. Results: 13C urea breath testing confirmed overall treatment success in 100% of patients (58/58) per protocol and 95.1% (58/61) on an intention-to-treat basis. At 4 and 12 months there were no differences in any GSRS symptoms between treatment groups. SF36 analysis showed a perceived health improvement at 4 and 12 months in patients who received H. pylori eradication. However, despite successful H. pylori eradication, one-fifth of patients still required antisecretory therapy. Conclusion: Following successful H. pylori eradication, chronic duodenal ulcer patients were at least as well symptomatically as when taking maintenance ranitidine. They perceived that their health had improved, but a subgroup was still acid-suppression dependent.
Databáze:	OpenAIRE
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