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