Email this article Esomeprasol in the treatment of duodenal ulcer under various regimens of antihelicobacter therapy
- Authors: Maev IV1, Kurilo AE1, Vyuchnova ES1, Schekina MI1
-
Affiliations:
- Московский государственный медико-стоматологический университет
- Issue: Vol 78, No 2 (2003)
- Pages: 23-26
- Section: Editorial
- URL: https://journals.rcsi.science/0040-3660/article/view/29307
- ID: 29307
Cite item
Full Text
Abstract
Aim. To assess efficiency of esomeprazole in the treatment of duodenal ulcer (DU) associated with Hpylori in various eradication regimens.
Material and methods. 80 patients with duodenal ulcer at least 0.5 cm in diameter were randomized into three groups. 23 patients of group 1, 28 patients of group 2 received esomeprazole for 7 days in a dose 20 mg twice a day, in a single morning dose 40 mg, respectively. 29 patients of group 3 received omeprazole 20 mg twice a day for 7 days and further 3 weeks 20 mg twice a day. All the patients were also given amoxicillin 1000 mg twice a day and clarithromycin 500 mg twice a day for a week. Results. An antisecretory effect of esomeprazole as shown by 24-h monitoring of gastric secretion was longer and more stable than that of omeprazole: a latent period averaged 1.5 ± 0.6 h in a pharmacological test with 20 mg esomeprazole, 1.2 ± 0.4 h in intake of 40 mg esomeprazole and 2.1 + 0.3 h in intake of 20 mg omeprazole. Overall duration of the antisecretory effect averaged 16.8 ± 1.9, 20.3 ±1.7 and 12.5 ± 1.9 h, respectively. The time of intragastric pH > 4 was 13.1 ± 1.6,
2
± 1.6 and 9.8 ± 1.5 hours, respectively. Eradication of H.pylori in group 1, 2 and 3 was 91.3,
3
and 89.6%, respectively. Complete epithelization of ulcer occurred in 95.6, 92.8 and 93.1% cases, respectively. In 77 patients who finished the treatment according to the protocol the treatment resulted in eradication in 95.6, 92.5 and 92.8%, respectively; in epithelization - in 100, 96.3 and 96.4% patients of groups 1, 2 and 3, respectively. Side effects were mild or moderate but not causing changes of the regimen or treatment discontinuation.
Conclusion. Esomeprazole in three-component treatment was highly effective in eradication of H. pylori and epithelisation of duodenal ulcer defects in various regimens of administration. Esomeprazole in combination with amoxicillin and clarithromycin reduces the time of treatment of DU associated with H. pylori to 1 week without further monotherapy with antisecretory drugs.
Material and methods. 80 patients with duodenal ulcer at least 0.5 cm in diameter were randomized into three groups. 23 patients of group 1, 28 patients of group 2 received esomeprazole for 7 days in a dose 20 mg twice a day, in a single morning dose 40 mg, respectively. 29 patients of group 3 received omeprazole 20 mg twice a day for 7 days and further 3 weeks 20 mg twice a day. All the patients were also given amoxicillin 1000 mg twice a day and clarithromycin 500 mg twice a day for a week. Results. An antisecretory effect of esomeprazole as shown by 24-h monitoring of gastric secretion was longer and more stable than that of omeprazole: a latent period averaged 1.5 ± 0.6 h in a pharmacological test with 20 mg esomeprazole, 1.2 ± 0.4 h in intake of 40 mg esomeprazole and 2.1 + 0.3 h in intake of 20 mg omeprazole. Overall duration of the antisecretory effect averaged 16.8 ± 1.9, 20.3 ±1.7 and 12.5 ± 1.9 h, respectively. The time of intragastric pH > 4 was 13.1 ± 1.6,
2
± 1.6 and 9.8 ± 1.5 hours, respectively. Eradication of H.pylori in group 1, 2 and 3 was 91.3,
3
and 89.6%, respectively. Complete epithelization of ulcer occurred in 95.6, 92.8 and 93.1% cases, respectively. In 77 patients who finished the treatment according to the protocol the treatment resulted in eradication in 95.6, 92.5 and 92.8%, respectively; in epithelization - in 100, 96.3 and 96.4% patients of groups 1, 2 and 3, respectively. Side effects were mild or moderate but not causing changes of the regimen or treatment discontinuation.
Conclusion. Esomeprazole in three-component treatment was highly effective in eradication of H. pylori and epithelisation of duodenal ulcer defects in various regimens of administration. Esomeprazole in combination with amoxicillin and clarithromycin reduces the time of treatment of DU associated with H. pylori to 1 week without further monotherapy with antisecretory drugs.
About the authors
I V Maev
Московский государственный медико-стоматологический университетМосковский государственный медико-стоматологический университет
A E Kurilo
Московский государственный медико-стоматологический университетМосковский государственный медико-стоматологический университет
E S Vyuchnova
Московский государственный медико-стоматологический университетМосковский государственный медико-стоматологический университет
M I Schekina
Московский государственный медико-стоматологический университетМосковский государственный медико-стоматологический университет
References
- Abelo A., Andersson Т., Antonsson M. et al. Stereoselective metabolism of omeprazole by human cytochrome P450 enzymes. Drug Metab. Dispos. 2000; 28: 966-972.
- Andersson Т., Rohss K., Hassan-Alin M. et al. Pharmacokineticks (PK) and dose-response relationship of esomcprazole (E). Gastoenterology 2000; 118(4, suppl. 2): 210. abstr. 5550.
- Andersson Т., Bredberg E., Sunzel M. et al. Pharmacokinetics (PK) and effect on pentagastrin stimulated peak acid output (POA) of omeprazole (O) and its 2 optical isomers, S-omeprazole/esomeprazole (E) and R-omeprazole (R-O). Ibid. 1210, abstr. 5551.
- Lind Т., Rydberg L., Kyleback A. et al. Esomcprazole provides improved acid control vs. omeprazole in patients with symptoms of gastro-oesophageal reflux disease. Aliment. Pharmacol. Ther. 2000; 14(7): 861-867.
- Rohss K., Claar-Nilsson C., Rydholm H. Esomcprazole 40 mg provides more effective acid control than lanzoprazole 30 mg. Gastroenterology 2000; 118: A20.
- Rohss K., Wilder-Smith С. H., Claar-Nilsson С. et al. Esomeprazole 40 mg provides more effective acid control than standard doses of all proton pump inhibitors [abstract]. Ibid. 2001; 120: abstr. 2140.
- Wilder-Smith C., Rohss K., Lundiri С. Esomeprazole (E) 40 mg provides more effective acid control than pantoprazole (P) 40 mg. Ibid. 2000; 118: A22.
- Veldhuyzen van Zanten S. J. O., Lauritsen K., Delchier J.-C. et al. 7-day triple therapy with esomeprazole, amoxicillin and clarithromycin for H. pylori (HP) eradication in duodenal ulcer (DU) disease [abstract and poster presented at Digestive Disease Week; 2000 May 21-24; San Diego, California]. Ibid. A503.
- Tulassay Z, Kryszewski A., Ditz P. et al. 7-day treatment esomeprazole-based triple therapy eradicates H. pylori (HP) and heals patient with DU disease [abstract and poster presented at Digestive Disease Week; 2000 May 21-24: San Diego, California]. Ibid. A502.
- Laine L., Fennerty В., Osato M. et al. Esomeprazole-based Helicobacter-pylori eradication therapy and effect of antibiotic resistance: Results of three US multicenter, double-blind trials. Ant. J. Gastroenterol. 2000: 95(12): 3393-3398.
- Karhilas P. J., Falk G. W., Johnson D. A. et al. Esomeprazole improves healing and symptom resolution as compared with omeprazole in reflux oesophagitis patients: a randomized controlled trial. The Esomeprazole Study Investigators. Aliment. Pharmacol. Ther. 2000. 14: 1249-1258.
- Richter J. E., Karhilas P. J., Hwang G. et al. Esomcprazole is superior for omeprazole for healing of erosive esophagitis (ЕЕ) in GERD patients [abstract and poster presented at Digestive Disease Week; 2000 May 21-24: San Diego, California]. Gastroenterology 2000; 118: A20.
- Talley N. J., Venables T. L., Green J. B. R. et al. Esomeprazole 40 mg and 20 mg is efficacious in the long-term management of patients with endoscopy-negative GERD: a placebo-controlled trial of on-demand therapy for 6 months [abstract]. Ibid. A658.
- Talley N. J., Lauritsen K., Tunturi-Hihnala H. et al. Esomeprazole 20 mg maitains symptom control in endoscopy-negative GERD: a randomized placebo-controlled trial of on-demand therapy for 6 month [abstract and poster presented at Digestive Disease Week; 2000 May 21-24: San Diego, California]. Ibid. A21.
Supplementary files
