Pantoprazole versus one-week Helicobacter pylori eradication therapy for the prevention of acute NSAID-related gastroduodenal damage in elderly subjects

Citation
A. Pilotto et al., Pantoprazole versus one-week Helicobacter pylori eradication therapy for the prevention of acute NSAID-related gastroduodenal damage in elderly subjects, ALIM PHARM, 14(8), 2000, pp. 1077-1082
Citations number
28
Categorie Soggetti
Pharmacology,"da verificare
Journal title
ALIMENTARY PHARMACOLOGY & THERAPEUTICS
ISSN journal
02692813 → ACNP
Volume
14
Issue
8
Year of publication
2000
Pages
1077 - 1082
Database
ISI
SICI code
0269-2813(200008)14:8<1077:PVOHPE>2.0.ZU;2-Q
Abstract
Aim: To compare the efficacy of pantoprazole vs. a one-week Helicobacter py lori eradication therapy for the prevention of NSAID-related gastroduodenal damage. Methods: Patients over 60 years old with symptoms and/or a history of ulcer who needed NSAID treatment were evaluated by endoscopy. H. pylori positive subjects who had no severe gastroduodenal lesions were randomized to take, concomitantly with NSAID therapy, either: (i) pantoprazole 40 mg daily plu s amoxycillin 1 g b.d. and clarithromycin 250 mg b.d. for 1 week (35 subjec ts, Group PAC) or (ii) pantoprazole 40 mg daily for 1 month (34 subjects, G roup P), Endoscopy was repeated after 1 month. Results:A significantly higher incidence of severe gastroduodenal damage wa s found in Group PAC than in Group P (29% vs. 9%, P < 0.05). The percentage s of patients worsened, unchanged and improved after 1 month were, respecti vely: Group PAC: 46%, 46%, and 9% and Group P: 7%, 65%, and 29% (P < 0.0008 ). The percentage of H. pylori-negative subjects was 89% in Group PAC and 5 2% in Group P (P = 0.0009), The incidence of gastroduodenal damage was high er in Group PAC treatment failures than in cured patients (50% vs. 25.8%, P = ns). Conclusion: One month of pantoprazole was more effective than a proton pump inhibitor-based triple therapy in the prevention of gastroduodenal damage in elderly H. pylori-positive NSAID users.