One-week triple therapy with esomeprazole provides effective eradication of Helicobacter pylori in duodenal ulcer disease

Background: Esomeprazole is the first proton pump inhibitor to be developed as an optical isomer for the treatment of acid-related diseases. Methods: Four hundred and forty eight duodenal ulcer patients with Helicoba cter pylori infection, confirmed by C-13-urea breath test (UBT), and no cur rent ulcer, were randomised to double-blind treatment with esomeprazole 20 mg twice daily (b.d.) (n=224) or omeprazole 20 mg b.d. (n=224), in combinat ion with amoxicillin 1 g b.d. and clarithromycin 500 mg b.d. for 1 week (EA C and OAC, respectively). A negative UBT at both 4 and 8 weeks after comple ting therapy indicated successful H. pylori eradication. Results: Intention-to-treat (ITT) analysis comprised 400 patients (EAC, n=2 04; OAC, n=196) and per protocol (PP) analysis 377 patients (EAC, n=192; OA C, n=185). Eradication rates (95% confidence intervals) for ITT and PP popu lations were: EAC, 90% (85-94%) and 91% (86-94%); OAC, 88% (82-92%) and 91% (86-95%). Between-group differences in eradication rates were not statisti cally significant. Both regimens were well tolerated, with an adverse event profile and frequency typical of proton pump inhibitor plus antibiotic com bination therapy. Conclusions: Esomeprazole-based triple therapy for 1 week is highly effecti ve in eradicating H. pylori infection in duodenal ulcer disease, offers com parable efficacy to omeprazole-based therapy, and is well tolerated.