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Comparison of esomeprazole and lansoprazole-based non-bismuth concomitant quadruple therapy to treat H. pylori

Comparison of esomeprazole and lansoprazole-based non-bismuth concomitant quadruple therapy to treat H. pylori Comparison of esomeprazole and lansoprazole-based non-bismuth concomitant quadruple therapy to treat H. pylori
Comparison of esomeprazole and lansoprazole-based non-bismuth concomitant quadruple therapy to treat H. pylori Comparison of esomeprazole and lansoprazole-based non-bismuth concomitant quadruple therapy to treat H. pylori

This retrospective analysis compared the rates of eradication of non-bismuth concomitant quadruple therapy comprising of either esomeprazole and lansoprazole for first-line anti-H. pylori treatment.

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Key take away

A seven-day concomitant treatment (non-bismuth concomitant quadruple therapy) with either esomeprazole or lansoprazole showed comparable rates of eradication in H.pylori infected patients. Also, the eradications were possibly affected by metronidazole-resistant strains.

Background

This retrospective analysis compared the rates of eradication of non-bismuth concomitant quadruple therapy comprising of either esomeprazole and lansoprazole for first-line anti-H. pylori treatment.

Method

In total, 206 H. pylori-infected patients were enrolled and assigned into two groups based on esomeprazole and lansoprazole based concomitant therapies as:

  • EACM group: Esomeprazole 40 mg + Amoxicillin 1 g + Metronidazole 500 mg; and Clarithromycin 500 mg all taken twice daily for 7 days
  • LACM group: Lansoprazole 30 mg + Amoxicillin 1 g + Metronidazole 500 mg; and Clarithromycin 500 mg  all taken twice daily

After 8 weeks, patients were asked to carry out urea breath tests.

Result

Rates of eradication in the EACM group and LACM group in intention-to-treat (ITT) and the per-protocol (PP) analysis is depicted in the following table:


Patients in the LACM group displayed more diarrhea compared to the EACM group (7.1% vs. 1.0%), however, all were mild symptoms. Metronidazole resistance was the clinical feature influencing the eradications as per the univariate analysis. Furthermore, a trend was witnessed in dual metronidazole- and clarithromycin-resistant strains. 

Conclusion

Non-bismuth concomitant quadruple therapy with either esomeprazole or lansoprazole provided similar outcomes concerning eradication rates for first-line therapy for H. pylori. In the PP analysis, both groups could attain more than 90% elimination of H. pylori.

Source:

Infection and Disease resistance

Article:

Eradication Rates for Esomeprazole and Lansoprazole-Based 7-Day Non-Bismuth Concomitant Quadruple Therapy for First-Line Anti-Helicobacter pylori Treatment in Real World Clinical Practice

Authors:

Kuo-Tung Hung al.

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