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A three-day octreotide-containing helicobacter pylori eradication therapy for cure of peptic ulcers
S D Ladas1, H Malamou-Lada, G Economou
1Second Department of Internal Medicine, Evangelismos Hospital, Athens University, Greece. sdladas@hol.gr
Insights
This study shows an ultra-short octreotide quadruple therapy effectively eradicates Helicobacter pylori and heals peptic ulcers. This safe and efficient treatment is suitable for hospitalized patients.
Area of Science:
- Gastroenterology
- Microbiology
- Pharmacology
Background:
- Octreotide is known for arresting peptic ulcer hemorrhage.
- Its anti-secretory properties suggest potential in Helicobacter pylori eradication therapy.
- Peptic ulcers require effective treatment before hospital discharge.
Purpose of the Study:
- To assess the safety and efficacy of an ultra-short quadruple therapy including octreotide.
- To evaluate this regimen for Helicobacter pylori eradication in peptic ulcer patients.
Main Methods:
- A pilot study involved 26 symptomatic H. pylori-positive patients with duodenal or gastric ulcers.
- Treatment consisted of a three-day course of octreotide, amoxicillin, metronidazole, and bismuth.
- H. pylori eradication and ulcer healing were assessed using CLO-test, culture, and smears at 4 and 8 weeks post-treatment.
Main Results:
- Octreotide significantly increased mean 24-hour intragastric pH above 3 for over 68.9% of the time.
- No treatment-related side effects were reported.
- Ulcer pain resolved within 2-12 days, with 92.3% ulcer healing at 4 weeks and an 88.5% H. pylori eradication rate at 8 weeks.
Conclusions:
- The ultra-short octreotide-containing quadruple therapy demonstrated safety and efficacy.
- This regimen is effective for eradicating H. pylori and healing peptic ulcers.
- It represents a potentially suitable therapeutic option for hospitalized peptic ulcer hemorrhage patients.
Background/Aims:
Octreotide is used to arrest peptic ulcer hemorrhage. Since it has anti-secretory properties, it could also be used in Helicobacter pylori eradication therapy, to cure peptic ulcer before discharging patients from hospital. The aim of this pilot study was to determine safety and efficacy of an ultra short quadruple octreotide containing H. pylori eradication therapy in patients with peptic ulcer.
Methodology:
Twenty-six consecutive symptomatic H. pylori-positive patients with duodenal (n = 20) or gastric ulcer (n = 6), were treated with a three-day course of octreotide 0.3 mg/day subcutaneously, amoxicillin plus metronidazole 2 g/day orally and colloid bismuth subcitrate 480 mg/day. CLO-test, culture and crush tissue smears were performed on admission to the study, at 4 and 8 weeks post treatment. The effect of octreotide on intragastric pH (n = 10) was also investigated.
Results:
Octreotide significantly increased the mean 24-hour intragastric pH > 3 over 68.9% of the time (37.1%-99.5%). There were no treatment side effects. Ulcer pain was abolished at between 2-12 days. By intention-to-treat 24/26(92.3%, 95% CI 82%-100%) ulcers had healed at 4 weeks. H. pylori eradication rate at 8 weeks was 88.5% (23/26) (95% CI 76%-100%).
Conclusions:
Our ultra-short octreotide containing quadruple therapy is a safe and effective regime in eradicating H. pylori and healing peptic ulcers. It may be a suitable therapy for hospitalized patients with peptic ulcer hemorrhage.