Miwa H, Yamada T, Sato K, Ohta K, Ohkura R, Murai T, Nagahara A, Takei Y, Ogihara T, Sato N
Department of Gastroenterology, Juntendo University, School of Medicine, Tokyo, Japan.
Dig Dis Sci. 2000 Jan;45(1):77-82. doi: 10.1023/a:1005409310412.
Proton pump inhibitor (PPI)- based triple therapy has been a recent trend for treatment of Helicobacter pylori infection, with the PPI-amoxicillin-clarithromycin (PPI/AC) regimen being one of the most popular. We have reported the effectiveness of PPI/AC regimens in the Japanese population and have demonstrated that the effectiveness of 40 mg rabeprazole, a recently developed PPI, is similar to that of 40 mg of omeprazole and 60 mg of lansoprazole when used in combination with amoxicillin and clarithromycin. In this study, we focused on whether 20 mg of rabeprazole is effective in our patient population by comparing that dosage with 40 mg of rabeprazole and 60 mg of lansoprazole. In all, 308 H. pylori-infected patients [236 men and 72 women; age (mean +/- SEM) 49.3+/-0.6 years] with peptic ulcer disease (N = 270) or nonulcer dyspepsia (N = 38) were randomly assigned to one of three different PPI/AC regimens for seven days: LAC (N = 104), consisting of lansoprazole 30 mg twice a day, amoxicillin 500 mg three times a day, and clarithromycin 200 mg twice a day; RAC (N = 104), consisting of rabeprazole 20 mg twice a day, amoxicillin 500 mg three times a day, and clarithromycin 200 mg twice a day; and the R1/2AC regimen (N = 100), which included rabeprazole 10 mg twice a day, amoxicillin 500 mg three times a day, and clarithromycin 200 mg twice a day. Cure of the infection was determined by the [13C]urea breath test one month after completion of the treatment. Intention-to-treat based and per-protocol based cure rates for the LAC, RAC, and R1/2AC regimens were 82.7 (95% CI, 74-89) and 88.7% (81-94), 85.6 (77-92) and 89.8% (82-95), and 87.0 (79-93) and 89.7% (82-95), respectively. Although adverse effects were reported by 20.3% of the patients, these affected compliance in only five patients in the RAC and LAC regimens and none in the R1/2AC group. Overall complete compliance was achieved in 94.7% of interviewed patients. In conclusion, the effectiveness of the PPI/AC regimen with 20 mg of rabeprazole is comparable with and even safer than that of 40 mg of rabeprazole and 60 mg of lansoprazole in our patient population.
基于质子泵抑制剂（PPI）的三联疗法是近期治疗幽门螺杆菌感染的一种趋势，其中PPI-阿莫西林-克拉霉素（PPI/AC）方案是最常用的方案之一。我们已经报道了PPI/AC方案在日本人群中的有效性，并证明了近期研发的PPI——40mg雷贝拉唑与40mg奥美拉唑和60mg兰索拉唑联合阿莫西林和克拉霉素使用时的有效性相似。在本研究中，我们通过将20mg雷贝拉唑的剂量与40mg雷贝拉唑和60mg兰索拉唑进行比较，来关注20mg雷贝拉唑在我们的患者群体中是否有效。总共308例幽门螺杆菌感染患者[236例男性和
