A Prospective Randomized Trial of Esomeprazole- versus Pantoprazole-Based Triple Therapy for Helicobacter pylori Eradication

Ping-I Hsu; Kwok-Hung Lai; Chiun-Ku Lin; Wen-Chi Chen; Hsien-Chung Yu; Jin-Shiung Cheng; Feng-Woei Tsay; Chung-Jen Wu; Ching-Chu Lo; Hui-Hwa Tseng; Yoshio Yamaoka; Jin-Liang Chen; Gin-Ho Lo
November 2005
American Journal of Gastroenterology;Nov2005, Vol. 100 Issue 11, p2387
Academic Journal
OBJECTIVE: This prospective, randomized, controlled, head-to-head study was conducted to compare the efficacies of esomeprazole- and pantoprazole-based triple therapies for Helicobacter pylori eradication. METHODS: From January 2002 to October 2003, 200 H. pylori-infected patients were randomly assigned to undergo twice daily treatment with esomeprazole 40 mg (n = 100) or pantoprazole 40 mg (n = 100) combined with clarithromycin 500 mg and amoxicillin 1 g for 1 wk (ECA and PCA groups, respectively). Follow-up endoscopy was performed at 8 wks after the end of treatment to assess the treatment response. RESULTS: Intention-to-treat analysis demonstrated a significantly higher eradication rate for the ECA group than for the PCA group (94% vs 82%, respectively, p= 0.009). Per-protocol analysis also showed similar results (97% vs 84%, p= 0.003). Both groups had similar frequencies of adverse events (15% vs 24%) and drug compliance (97% vs 96%). Multivariate analysis disclosed that the use of esomeprazole (OR: 1.56, 95% CI, 1.11–2.19) and good compliance 7.39 (95% CI, 1.27–42.95) were independent predictors of treatment success. Alcohol drinking was an independent predictor of eradication failure (OR: 0.18; 95% CI, 0.06–0.54). CONCLUSION: Esomeprazole-based triple therapy demonstrated a higher eradication rate than pantoprazole-based regimen. The differences in eradiation efficacies between the two study groups may be related to the more powerful acid inhibition effect and stronger anti- H. pylori activity of esomeprazole compared to pantoprazole.


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