INCIDENCE OF DUODENAL-ULCER HEALING AFTER 1 WEEK OF PROTON PUMP INHIBITOR TRIPLE THERAPY FOR ERADICATION OF HELICOBACTER-PYLORI

Background: A number of clinical studies have assessed the efficacy of short-term twice-daily Helicobacter pylori eradication regimens but f ew have investigated the proportion of patients in whom duodenal ulcer disease was healed with these regimens. Aim: To compare the safety an d efficacy of four 1-week H. pylori eradication regimens in the healin g of H. pylori associated duodenal ulcer disease. Methods: Following e ndoscopic confirmation of duodenal ulcer disease and a positive CLO te st, patients underwent a C-13-urea breath test to confirm H. pylori st atus. Treatment with one of four regimens: LAG, LAM, LCM or OAM, where L is lansoprazole 30 mg b.d,, A is amoxycillin 1 g b.d., M is metroni dazole 400 mg b.d., C is clarithromycin 250 mg b,d., and O is omeprazo le 20 mg b.d., was assigned randomly to those patients who were H. pyl ori positive, with 62 (LAC), 64 (LAM), 61 (LCM) and 75 (OAM) patients in each treatment group. Follow-up breath tests and endoscopies were p erformed at least 28 days after the end of treatment. Results: Duodena l ulcer disease was healed 28 days after treatment in 53/62 (85.5%) pa tients who were treated with LAG, 52/64 (81.3%) of patients treated wi th LAM, 49/61 (80.3%) of patients treated with LCM and 60/75 (80.0%) o f patients treated with OAM (intention-to-treat analysis, n = 262, ass umed unhealed if no followup endoscopy was performed). All the treatme nts were of similar efficacy (P = 0.85, chi-squared test) with regard to the healing of duodenal ulcer disease. Conclusions: The four 1-week treatment regimens were equally effective in healing H. pylori associ ated duodenal ulcer disease.