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Chunlertlith K, Limpapanasit U, Mairiang P, et al. Outcomes of a Randomized Controlled Trial Comparing Modified High Dose Omeprazole and Amoxicillin Triple Therapy with Standard Triple Therapy for Helicobacter Pylori Eradication. Asian Pac J Cancer Prev. 2017;18(4):927-932doi: 10.22034/APJCP.2017.18.4.927.
Chunlertlith, K., Limpapanasit, U., Mairiang, P., Vannaprasaht, S., Tassaneeyakul, W., Sangchan, A., Sawadpanich, K., Suttichaimongkol, T., Pongpit, J., & Pattarapongsin, M. (2017). Outcomes of a Randomized Controlled Trial Comparing Modified High Dose Omeprazole and Amoxicillin Triple Therapy with Standard Triple Therapy for Helicobacter Pylori Eradication. Asian Pacific journal of cancer prevention : APJCP, 18(4), 927-932. https://doi.org/10.22034/APJCP.2017.18.4.927
Chunlertlith, Kitti, et al. "Outcomes of a Randomized Controlled Trial Comparing Modified High Dose Omeprazole and Amoxicillin Triple Therapy with Standard Triple Therapy for Helicobacter Pylori Eradication." Asian Pacific journal of cancer prevention : APJCP vol. 18,4 (2017): 927-932. doi: https://doi.org/10.22034/APJCP.2017.18.4.927
Chunlertlith K, Limpapanasit U, Mairiang P, Vannaprasaht S, Tassaneeyakul W, Sangchan A, Sawadpanich K, Suttichaimongkol T, Pongpit J, Pattarapongsin M. Outcomes of a Randomized Controlled Trial Comparing Modified High Dose Omeprazole and Amoxicillin Triple Therapy with Standard Triple Therapy for Helicobacter Pylori Eradication. Asian Pac J Cancer Prev. 2017 Apr 01;18(4):927-932. doi: 10.22034/APJCP.2017.18.4.927. PMID: 28545189; PMCID: PMC5494241.
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Asian Pac J Cancer Prev. 2017 Apr 01;18(4):927-932. doi: 10.22034/APJCP.2017.18.4.927.

Outcomes of a Randomized Controlled Trial Comparing Modified High Dose Omeprazole and Amoxicillin Triple Therapy with Standard Triple Therapy for Helicobacter Pylori Eradication.

Asian Pacific journal of cancer prevention : APJCP

Kitti Chunlertlith, Uaepong Limpapanasit, Pisaln Mairiang, Suda Vannaprasaht, Wichittra Tassaneeyakul, Apichat Sangchan, Kookwan Sawadpanich, Tanita Suttichaimongkol, Jamrus Pongpit, Moragot Pattarapongsin

Affiliations

  1. Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, KhonKaen University, Thailand. Email: [email protected]

PMID: 28545189 PMCID: PMC5494241 DOI: 10.22034/APJCP.2017.18.4.927

Abstract

Background: Helicobacter pylori (H. pylori) infection is related to peptic ulcer diseases and gastric cancer and eradication of H. pylori should be expected to decrease the risk of their development. Factors affecting H. pylori eradication are antibiotic resistance, CYP2C19 genotypes, drug regimen and patient compliance. Increment of omeprazole and amoxicillin dosage in clarithromycin-containing triple therapy regimen may overcome these problems and may be a better choice than the conventional clarithromycin-containing triple therapy regimen. Objective: To compare the eradication rates with modified triple therapy (MTT) and standard triple therapy (STT) as first-line treatment. Materials and Methods: The study was an open label, multicenter, randomized controlled trial. A total of 170 patients infected with H. pylori diagnosed by rapid urease test were randomly assigned into 2 groups. The first was treated with a 14-day MTT (20 mg omeprazole t.i.d., 500 mg amoxicillin t.i.d., and 500 mg clarithromycin b.i.d.) and the second with a 14-day STT (20 mg omeprazole b.i.d., 1000 mg amoxicillin b.i.d., and 500 mg clarithromycin b.i.d.). H. pylori eradication was evaluated by 14C-urea breath test. CYP2C19 genotypes, clarithromycin resistance, side effects and patient compliance were also recorded. Results: There were 85 patients in each group. The H. pylori eradication rate in the MTT group was 84.7% by ITT analysis and 91.1% by PP analysis, compared to the STT group values of 76.5% and 87.8% (p = 0.18 and 0.51), respectively. CYP2C19 genotypes and patient compliance were similar in both groups. Prevalence of clarithromycin resistance was 7.0%. Side effects were all mild with no significant differences between the twogroups. Conclusions: MTT is not superior to STT. From this study, MTT may not be recommended as the first-line treatment for H. pylori infection in Thailand because eradication rates proved to be less than 90% by ITT analysis.

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Keywords: Modified high dose; omeprazole; amoxicillin; triple therapy; Helicobacter pylori eradication; Thailand

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