Rabeprazole-based eradication therapy for Helicobacter pylori: A large-scale study in Japan

H. Kuwayama, K. Asaka, T. Sugiyama, Y. Fukuda, N. Aoyama, Y. Hirai, T. Fujioka, Gakuyo Karasawa, Ryo Uyama, Mototsugu Kato, Yuichi Shimizu, Souichi Nakagawa, Ken Nishi, Shigeru Ozasa, Mineo Kudo, Takahiro Kamata, Masao Saito, Naoyuki Kawamura, Masako Tsuyuguchi, Hiroko OoizumiTakeaki Kobayashi, Asako Iijima, Tsuyoshi Yabana, Kazuyoshi Yamashita, Youji Harada, Teitetsu Niido, Yuri Yasuda, Yoko Iga, Hajime Kuwayama, Morio Takahashi, Hironobu Takada, Hiroshi Takada, Shigeki Oka, Hiroki Ichimura, Eiko Makino, Kazumasa Miki, Jun Miwa, Yasuo Matsubara, Takashige Tomita, Shigeru Koyama, Nobuhiro Sakaki, Masahiko Takahashi, Haruko Yokoyama, Yuji Koike, Tuyo To, Yoshiharu Satake, Makiyo Machida, Takashi Kawai, Satoru Taira, Kenji Nukaga, Naomi Uemura, Jyunichi Akiyama, Yuko Hiraga, Hitohiko Koizuka, Shigeaki Yasaka, Ryosuke Tajiri, Masao Kobayakawa, Akitaka Takahara, Mika Shimamoto, Hiroshi Murata, Toshihide Okada, Yoshihide Fujiyama, Shigeki Koyama, Masaya Sasaki, Tomoyuki Tsujikawa, Izumi Ishizuka, Kiyoshi Ashida, Hajime Takahashi, Takumi Fukuchi, Naomi Kiyota, Hiroshi Yamashita, Reiko Tsukamoto, Hiroshi Ito, Tomohiro Nishide, Haruki Kato, Takashi Ando, Koichi Terao, Nobuo Aoyama, Daisuke Shirasaka, Takao Tamura, Shunichi Yoshida, Seiichi Hirano, Yoshihiro Fukuda, Kazutoshi Hori, Toshihiko Tomita, Tahashi Sakagami, Kazuhiko Inoue, Mutsumi Hananoki, Norio Miyashima, Hirotsugu Okuda, Kazuhiro Harada, Toshihiro Honda, Masaharu Takeda, Ken Haruma, Toru Hidaka, Hiroaki Oogoshi, Shinji Nagata, Akira Tari, Hiroshi Tani, Hiroshi Mieno, Mitsuhiro Mihara, Yoshihiro Wada, Tomohiko Shimatani, Masaki Inoue, Takashi Kobayashi, Kazuhiko Yamauchi, Makoto Tsugita, Nobutoshi Kuniyoshi, Kazuma Fujimoto, Ryuichi Iwakiri, Hiroyuki Sakata, Seiji Tsunada, Akifumi Ootani, Atsushi Kikkawa, Yoshihiro Eriguchi, Koji Fukuyama, Masahiro Hattori, Tomofumi Tanaka, Kiwamu Hasuda, Hideyo Goto, Toshio Fujioka, Ryugo Sato, Kazunari Murakami, Masaaki Kodama, Tadayoshi Okimoto, Hajime Miyajima, Masami Ono, Tsuyoshi Arita, Syunzo Sato, Hisanori Abe

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Abstract

Background: Large-scale studies of rabeprazole-based Helicobacter pylori eradication therapy have not been reported in Japan. Aims: To evaluate H. pylori eradication by rabeprazole-based therapy with reference to antibiotic susceptibility, CYP2C19 genotype, and rabeprazole and clarithromycin dosages. Methods: From 35 centres 479 H. pylori-positive patients with gastric or duodenal ulcer were randomized to four treatment groups: Group 1 (10 mg rabeprazole + 750 mg amoxicillin + 200 mg clarithromycin twice daily for 7 days); Group 2 (10 mg, 750 mg, 400 mg); Group 3 (20 mg, 750 mg, 200 mg) and Group 4 (20 mg, 750 mg, 400 mg). Results: Eradication rates were 86% (102 of 119), 89% (97 of 109), 91% (106 of 116) and 90% (104 of 115) for Groups 1-4, respectively. The eradication rate was 95% (360 of 379) for clarithromycin- susceptible strains, and 50% (30 of 60) for clarithromycin-resistant strains. The eradication rates were 88% (332 of 379) and 96% (77 of 80) in extensive metabolizers and poor metabolizers, respectively. Conclusions: Rabeprazole-based therapies achieved 50% eradication of clarithromycin-resistant H. pylori, and even achieved good rates in extensive metabolizers. Accordingly, rabeprazole can be recommended as part of a first-line proton pump inhibitor-based triple therapy for H. pylori.

Original languageEnglish
Pages (from-to)1105-1113
Number of pages9
JournalAlimentary Pharmacology and Therapeutics
Volume25
Issue number9
DOIs
Publication statusPublished - May 1 2007

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All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology
  • Pharmacology (medical)

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