Improvement in symptoms after H(2)-receptor antagonist-based therapy for eradication of H pylori infection.

Author(s): Hagiwara T, Kato M, Anbo T, Imamura A, Suga T, Uchida T, Fujinaga A, Nakagawa M, Nakagawa S, Shimizu Y, Yamamoto J, Takeda H, Asaka M

Affiliation(s): Division of Endoscopy, Hokkaido University Hospital, Nishi-5, Kita-14, Kita-ku, Sapporo, Hokkaido 060-4876, Japan. m-kato@med.hokudai.ac.jp.

Publication date & source: 2007-07-28, World J Gastroenterol., 13(28):3836-40.

Publication type:

AIM: To investigate the therapeutic effects of triple therapy combining lafutidine with clarithromycin and amoxicillin on H pylori infection and the resolution of gastroesophageal symptoms after eradication. METHODS: We conducted a randomized, multicenter, open-label controlled trial to compare the effectiveness of a triple therapy of lafutidine, clarithromycin, and amoxicillin (lafutidine group) with that of a triple therapy of lansoprazole, clarithromycin, and amoxicillin (lansoprazole group) in patients with H pylori infection. The study group comprised 22 patients with gastric ulcers and 18 patients with duodenal ulcers who had H pylori infection. RESULTS: H pylori eradication rates were similar in the lafutidine group (14/20, 70%) and the lansoprazole group (14/20, 70%). Gastroesophageal reflux and abdominal symptoms improved after eradication therapy in both groups, whereas abdominal discomfort, diarrhea, and constipation were unchanged. H pylori status had no apparent effect on improvement of gastroesophageal reflux or abdominal symptoms after treatment. Adverse events were similar in both groups. CONCLUSION: The triple therapy including lafutidine is equivalent to triple therapy including lansoprazole in terms of H pylori eradication rates and improvement in gastroesophageal reflux and abdominal symptoms. These results are attributed to the fact that lafutidine has strong, continuous antisecretory activity, unaffected by CYP2C19 polymorphisms.