Comparison of rabeprazole-based four- and seven-day triple therapy and omeprazole-based seven-day triple therapy for Helicobacter pylori infection in patients with peptic ulcer.

BACKGROUND AND PURPOSE: Rabeprazole is a new proton pump inhibitor producing rapid inhibition of gastric acid secretion. This may potentiate the inhibitory effect of antibiotics against Helicobacter pylori. This study compared the efficacy, safety, and tolerability of 4- and 7-day rabeprazole-based triple therapies versus 7-day omeprazole-based triple therapy. METHODS: A total of 70 H. pylori-infected peptic ulcer patients were randomly assigned to 1 of 3 groups: RAC4 (rabeprazole 20 mg, amoxicillin 1000 mg, and clarithromycin 500 mg twice daily for 4 days), RAC7 (rabeprazole 20 mg, amoxicillin 1000 mg, and clarithromycin 500 mg twice daily for 7 days), and OAC7 (omeprazole 20mg, amoxicillin 1000 mg, and clarithromycin 500 mg twice daily for 7 days). Endoscopy, Campylobacter-like organism (CLO) test, H. pylori culture, and 13C-urea breath test were performed before randomization and 8 weeks after the start of triple therapy. RESULTS: Intention-to-treat (ITT) eradication rates for the RAC4, RAC7, and OAC7 groups were 87% (20/23), 83%(19/23), and 88% (21/24), respectively, and per-protocol (PP) eradication rates were 91% (20/22), 95% (19/20), and 100% (21/21), respectively. There was no significant difference among the ITT or PP eradication rates of the 3 groups. All 3 regimens were well tolerated and compliance was excellent. CONCLUSIONS: One-week RAC and 1-week OAC are equally effective for H. pylori eradication in peptic ulcer patients. The duration of RAC triple therapy can be shortened to 4 days without compromising its efficacy.