Is a one-week course of triple anti-Helicobacter pylori therapy sufficientto control active duodenal ulcer?

Background: Triple therapy currently forms the cornerstone of the treatment of patients with Helicobacter pylori-positive duodenal ulcer. Aim: To establish whether prolonged antisecretory therapy is necessary in p atients with active duodenal ulcer. Methods: A total of 77 patients with H. pylori-positive duodenal ulcer were included in a prospective, controlled, double-blind study. All patients re ceived a 7-day treatment with omeprazole 20 mg b.d., clarithromycin 500 mg b.d. and amoxicillin 1000 mg b.d. Patients in the omeprazole group underwen t an additional 14-day therapy with omeprazole 20 mg; patients in placebo g roup received placebo. Endoscopy was performed upon inclusion in the study and after 3 and 8 weeks. Results: Seventy-four patients were eligible for a per protocol analysis af ter 3 weeks, and 65 after 8 weeks. After 3 weeks, the healing rate was 89% in the omeprazole group and 81% in the placebo group (P = 0.51). After 8 we eks, the ulcer healed in 97% of the patients in the total group (95% CI: 92 .7-100%). H. pylori was eradicated in 88% of patients in the omeprazole gro up and in 91% in the placebo group (P = 1.0). No statistically significant differences between the groups were found in ulcer-related symptoms or in u lcer healing. Conclusion: In patients with H. pylori-positive duodenal ulcer, a 7-day tri ple therapy alone is sufficient to control the disease.