The First-Line Eradication Rate for Helicobacter pylori Infection in Functional Dyspepsia Patients

Abstract

AIM: The eradication rates of a first-line eradication regimen for Helicobacter pylori (H. pylori) infection in patients with peptic ulcer disease (PUD) and functional dyspepsia (FD) were compared. The eradication rates in distinction from proton pump inhibitors (PPIs) were also investigated. METHODS: A total of 339 H. pylori infected patients were enrolled in this study. PPI [lansoprazole (L) 30 mg bid, omeprazole (O) 20 mg bid or rabeprazole (R) 10 mg bid] was randomly allocated along with amoxicillin (A) 750 mg bid and clarithromycin (C) 400 mg bid (L60A1500C800, O40A1500C800, or R20A1500C800) by the envelope method. RESULTS: Of 339 patients, 111 had PUD and 126 patients had FD. All patients underwent a gastrointestinal endoscopy for confirmation of the presence of gastroduodenal disease. The eradication rates of H. pylori in PUD patients obtained with the three regimens were similar. On the other hand, the eradication rate in FD patients was lower than that in the PUD patients (69.8%, 81.1%, respectively, P=0.0458). The eradication rate with R20A1500C800 was significantly lower in the FD patients than in the PUD patients, according to both ITT and PP analysis (P=0.0458, P=0.0161, respectively). Data analysis revealed that the lower eradication rate obtained in FD patients was attributable to the use of the R20A1500C800 regimen. The overall frequency of adverse events was 32.9%. CONCLUSION: The eradication rate in the first-line R-based regimen used for FD patients was very low (ITT: 54.1%, PP: 57.1%) compare with L-based regimen.