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The OAC and OMC options.
1Department of Medicine, Länssjukhuset Gävle Sandviken, Gävle, Sweden. peter.unge@lsgs.lg.se
European Journal of Gastroenterology & Hepatology
|September 30, 1999
Summary
Omeprazole triple therapy, including OAC or OMC, effectively eradicates Helicobacter pylori in peptic ulcer patients. These well-tolerated regimens also reduce ulcer relapse rates, demonstrating high efficacy.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Pharmacology
Background:
- Peptic ulcer disease is often caused by Helicobacter pylori infection.
- Previous studies identified omeprazole-amoxycillin-clarithromycin (OAC) and omeprazole-metronidazole-clarithromycin (OMC) as successful H. pylori eradication regimens.
- Further investigation was needed to confirm the efficacy and safety of these regimens in diverse patient populations.
Purpose of the Study:
- To evaluate the efficacy of OAC and OMC regimens in eradicating H. pylori in patients with active or healed peptic ulcers.
- To assess the impact of omeprazole on eradication rates when combined with amoxycillin-clarithromycin (AC) or metronidazole-clarithromycin (MC).
- To determine ulcer healing and relapse rates associated with these treatment regimens.
Main Methods:
- Three double-blind, randomized, international, multi-centre studies (MACH2, DU-MACH, GU-MACH) were conducted.
- Participants received OAC, AC, OMC, MC, or omeprazole alone for H. pylori eradication.
- Eradication rates, ulcer healing, and ulcer relapse were the primary outcome measures.
Main Results:
- The addition of omeprazole significantly increased H. pylori eradication rates for both AC (26% to 94%) and MC (69% to 87%) regimens.
- High eradication and ulcer healing rates were observed with OAC and OMC in patients with active peptic ulcers.
- Ulcer relapse was significantly lower in the OAC and OMC groups compared to other regimens. Regimen efficacy was largely unaffected by primary metronidazole resistance, but reduced by 15% for OMC in the presence of resistance.
Conclusions:
- Omeprazole triple therapy (OAC and OMC) is a highly effective treatment for H. pylori eradication in patients with active or healed peptic ulcer disease.
- These regimens demonstrate excellent tolerability and contribute to reduced ulcer relapse rates.
- The findings support the use of omeprazole-based triple therapy as a standard of care for H. pylori-associated peptic ulcers.