Randomized trial comparing rabeprazole- versus lansoprazole-based Helicobacter pylori eradication regimens

Area of Science:

• Gastroenterology
• Infectious Diseases
• Pharmacology

Background:

• Proton pump inhibitor (PPI)-based triple therapies are crucial for Helicobacter pylori eradication.
• Variations in PPI choice may influence treatment outcomes.

Purpose of the Study:

• To compare the efficacy and safety of rabeprazole-based versus lansoprazole-based triple therapies for primary H. pylori infection treatment.

Main Methods:

• A randomized trial involving 426 H. pylori-infected patients.
• 7-day triple therapy with rabeprazole or lansoprazole, amoxicillin, and clarithromycin.
• H. pylori status assessed via esophagogastroduodenoscopy and/or C-urea breath test 12-16 weeks post-treatment.

Main Results:

• Intention-to-treat eradication rates were 87.84% for rabeprazole (RAC) and 85.96% for lansoprazole (LAC) (p=0.56).
• Compliance was high in both groups (LAC 100%, RAC 99.50%).
• Adverse event rates were similar (RAC 7.20%, LAC 5.70%).
• NSAID use was associated with lower eradication rates (76.71% vs. 88.74%, p=0.006).

Conclusions:

• Rabeprazole- and lansoprazole-based triple therapies demonstrate comparable efficacy and safety for H. pylori eradication.
• The impact of non-steroid anti-inflammatory agent (NSAID) use on eradication rates requires further research.