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Is a one-week course of triple anti-Helicobacter pylori therapy sufficient to control active duodenal ulcer?
B Tepes1, I Krizman, M Gorensek
1Medical Center Rogaska, Rogaska Slatina, Slovenia. bojan.tepes@rogaska.com
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 patients 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 received 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 underwent an additional 14-day therapy with omeprazole 20 mg; patients in placebo group 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 after 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 weeks, 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 group 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 ulcer healing.
Conclusion:
In patients with H. pylori-positive duodenal ulcer, a 7-day triple therapy alone is sufficient to control the disease.
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