scholarly journals Ranitidine bismuth citrate with clarithromycin for the treatment of duodenal ulcer

Gut ◽  
1997 ◽  
Vol 41 (2) ◽  
pp. 181-186 ◽  
Author(s):  
K D Bardhan ◽  
C Dallaire ◽  
H Eisold ◽  
A E Duggan
Keyword(s):  
Duodenal Ulcer ◽  
Ulcer Healing ◽  
Eradication Therapy ◽  
Dual Therapy ◽  
Ulcer Recurrence ◽  
Bismuth Citrate ◽  
Ulcer Relapse ◽  
Table Analysis ◽  
Duodenal Ulcer Healing ◽  
H Pylori

Background/Aims—To investigate the effect of the new Helicobacter pylori eradication regimen, ranitidine bismuth citrate (RBC) and clarithromycin (CLAR) dual therapy, on duodenal ulcer healing and absence of ulcer recurrence during 24 weeks follow up (overall success).Methods—Two hundred and thirty two H pylori positive patients with active duodenal ulcer received four weeks treatment with RBC 400 mg twice daily alone (RBC400) (n=82), or RBC 400 or 800 mg twice daily co-prescribed with clarithromycin 250 mg four times daily for 14 days, followed by 14 days of RBC 400 mg twice daily alone (RBC400+CLAR and RBC 800+CLAR, respectively, n=75 for each).Results—The co-prescription regimens gave highH pylori eradication rates determined using two tests (CLOtest and 13C-urea breath test) for the presence of the organism. These rates were 92% and 81% for RBC400+CLAR (n=62) and RBC800+CLAR (n=63) respectively, compared with 2% for RBC400 (n=66) (p<0.001). With respect to overall success as estimated by life table analysis, RBC400+CLAR (89%) and RBC800+ CLAR (87%) were significantly more effective than RBC400 alone (51%) (p<0.001). All regimens were safe and well tolerated. Trough plasma bismuth concentrations at week 4 were low (treatment medians less than 6.6 ng bismuth/ml).Conclusions—Ranitidine bismuth citrate is a well tolerated and efficacious ulcer healing drug which, when co-prescribed with clarithromycin, affords effective H pylorieradication therapy and prevents ulcer relapse in most patients with duodenal ulcer.

Effect of the eradication ofHelicobacter pylori on duodenal ulcer healing and ulcer relapse: Randomized controlled study in Japan

1996 ◽  
Vol 31 (2) ◽  
pp. 175-181 ◽  
Author(s):  
Takuro Shirotani ◽  
Mitsuo Okada ◽  
Hiroshi Murayama ◽  
Kazuhiro Maeda ◽  
Mitsuru Seo ◽  
...  
Keyword(s):  
Duodenal Ulcer ◽  
Ulcer Healing ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Randomized Controlled ◽  
Ulcer Relapse ◽  
Duodenal Ulcer Healing

scholarly journals Helicobacter pylori and Gastric Metaplasia: Their Status after Eradication Therapy

1970 ◽  
Vol 15 (2) ◽  
pp. 59-63
Author(s):  
Maleeha Hussain ◽  
Mian Ahmad Mashud ◽  
Hazera Khatun ◽  
Tareak Al Nasir
Keyword(s):  
Duodenal Ulcer ◽  
Helicobacter Pylori ◽  
Eradication Therapy ◽  
Ulcer Recurrence ◽  
Ulcer Margin ◽  
Gastric Metaplasia ◽  
H Pylori ◽  
The Relationship

This study was carried out with an aim to investigate the relationship between gastricmetaplasia with H. pylori and the effect of eradication therapy. A total of 210 patients withhistory of dyspepsia were included in the study of which 50 were enrolled in the eradicationtherapy. After the eradication therapy 35 patients came for follow-up endoscopy. Pairedendoscopic biopsies were taken from antrum and duodenal ulcer margin and were examined forH. pylori and for duodenitis and gastric metaplasia. Gastric metaplasia was significantlyassociated with H. pylori. After eradication H. pylori showed further extension of gastricmetaplasia. It can be recommended that these patients can be further followed up to see thecourse of gastric metaplasia and what impact it has on ulcer recurrence and re-infection.doi: 10.3329/taj.v15i2.3908TAJ December 2002; Vol.15(2):59-63

scholarly journals Does the Depth of Gastric Ulceration Influence a Modified Dual Therapy with Amoxicilin and Lansoprazole forHelicobacter pylori-Positive Gastric Ulcer?

2000 ◽  
Vol 14 (9) ◽  
pp. 761-766 ◽  
Author(s):  
Takashi Okai ◽  
Koushiro Ohtsubo ◽  
Junta Sakai ◽  
Hiroyuki Watanabe ◽  
Yoshiharu Motoo ◽  
...  
Keyword(s):  
Gastric Ulcer ◽  
Eradication Therapy ◽  
Dual Therapy ◽  
Ulcer Recurrence ◽  
Ecabet Sodium ◽  
Antiulcer Agent ◽  
Superficial Ulcer ◽  
H Pylori ◽  
One Year ◽  
To Receive

PURPOSE: To clarify whether the depth of ulceration evaluated by endoscopic ultrasonography (EUS) influences a modified dual therapy with amoxicillin and lansoprazole for the treatment ofHelicobacter pylori-positive patients with gastric ulcer.PATIENTS AND METHODS: Twenty-two consecutive cases of gastric ulcer (nine superficial ulcers and 13 deep ulcers) inH pylori-positive patients were studied. Ten of 22 patients received a two-week eradication therapy with amoxicillin 1500 mg/day, lansoprazole 30 mg/day and a new antiulcer agent with features in common with sucralfate, ecabet sodium, 2.0 g/day. They continued to receive the same doses of lansoprazole and ecabet sodium for the next six weeks. The other 12 patients received the same therapy except for those who underwent the four-week amoxicillin treatment. All patients underwent EUS both at the start of the study and eight weeks later. They then received ecabet sodium alone for the next six months as a maintenance therapy, followed by a six-month interval with no treatment. The final endoscopy was done one year afterH pylorieradication therapy was completed to evaluateH pyloristatus and ulcer recurrence.RESULTS: The rates of endoscopic healing andH pylorieradication in the nine patients with superficial ulcer were 100%, irrespective of the period of amoxicillin treatment. In contrast, the rates of endoscopic evidence of healing andH pylorieradication in the 13 patients with deep ulcer were different for each period of amoxicillin treatment; that is, the rates of reduction in ulcer determined by echo andH pylorieradication in the four patients treated with the two-week amoxicillin course were significantly lower (P=0.03) than those in the nine patients treated with the four-week course.CONCLUSION: Ulcer depth is likely to influence the success of amoxicillin treatment forH pylori-positive patients with gastric ulcer.

scholarly journals Helicobacter pylori: Basic Mechanisms to Clinical Cure

1995 ◽  
Vol 9 (2) ◽  
pp. 91-95 ◽  
Author(s):  
ABR Thomson ◽  
CN Williams
Keyword(s):  
Gastric Cancer ◽  
Duodenal Ulcer ◽  
Helicobacter Pylori ◽  
Peptic Ulcer ◽  
Clinical Cure ◽  
Eradication Therapy ◽  
Dual Therapy ◽  
Quadruple Therapy ◽  
Ulcer Disease ◽  
H Pylori

Since its rediscovery 10 years ago,Helicobacter pylorihas reshaped our thinking about the course of peptic ulcer disease. Our approach to the patient with a duodenal ulcer has become one of attempting eradication therapy at the time of first diagnosis, in the hope of curing the ulcer disease. Gastric and duodenal ulceration are only two of the manifestations of this chronic antral infection; other complications ofH pyloriinclude gastritis, gastric cancer and possible maltomas. Therapy ofH pyloriinfection is complicated and involves dual therapy with an antibiotic plus a protein pump inhibitor, such as omeprazole 20 mg bid plus amoxicillin 1 g bid for two weeks, triple or quadruple therapy with bismuth, two antibiotics and an H2-receptor antagonist. Vaccination againstH pyloriis on the far horizon.

Ranitidine Bismuth Citrate in the Treatment of Helicobacter Pylori Infection and Duodenal Ulcer

1998 ◽  
Vol 32 (6) ◽  
pp. 672-679 ◽  
Author(s):  
Thomas G Vondracek
Keyword(s):  
Duodenal Ulcer ◽  
Helicobacter Pylori ◽  
Adverse Effects ◽  
Ulcer Healing ◽  
English Language ◽  
Protective Effects ◽  
Double Blind ◽  
Medline Search ◽  
Bismuth Citrate ◽  
Duodenal Ulcer Healing

OBJECTIVE: To review the clinical pharmacology of ranitidine bismuth citrate in the treatment of Helicobacter pylori (HP) Infection and Duodenal Ulcer. DATA SOURCES: A MEDLINE search of the English-language literature from 1992 to January 1997 was conducted using the key terms Tritec, ranitidine, and bismuth. References of articles pertaining to treatment of duodenal ulcer or HP were extensively searched for relevant sources. DATA EXTRACTION: All articles pertaining to ranitidine bismuth citrate were considered for inclusion, with emphasis placed on randomized, double-blind trials. Priority was placed on data pertaining to regimens that are currently approved by the Food and Drug Administration for the treatment of duodenal ulcer in conjunction with HP. DATA SYNTHESIS: Each tablet of ranitidine bismuth citrate 400 mg contains 162 mg of ranitidine base, 128 mg of trivalent bismuth, and 110 mg of citrate. It uses the acid-suppressive actions of ranitidine and the antimicrobial and mucosal protective effects of bismuth to eradicate HP. Ranitidine bismuth citrate in conjunction with clarithromycin represents one of four treatment regimens currently approved in the US for duodenal ulcer associated with HP infection. In four double-blind, randomized trials, this agent has achieved HP eradication rates of 73–94% and duodenal ulcer healing rates of 73–89%. It is given twice daily for 28 days, and is associated with very low rates of adverse effects. CONCLUSIONS: Relative to some therapeutic alternatives, ranitidine bismuth citrate plus clarithromycin may be simpler to take and have less adverse effects, but may be more expensive. Compared with omeprazole plus clarithromycin, it is less expensive, may have lower ulcer healing rates, but may be more effective in eradicating HP. The role of ranitidine bismuth citrate will continue to evolve as more patients are treated, and other regimens continue to be tested for duodenal ulcer healing and HP eradication.

Ulcer recurrence following duodenal ulcer healing with omeprazole, ranitidine, or placebo: A double-blind, multicenter, 6-month study

1992 ◽  
Vol 102 (4) ◽  
pp. 1289-1294 ◽  
Author(s):  
David Y Graham ◽  
Juan Colon-Pagan ◽  
Richard S Morse ◽  
Thomas L Johnson ◽  
John H Walsh ◽  
...  
Keyword(s):  
Duodenal Ulcer ◽  
Ulcer Healing ◽  
Ulcer Recurrence ◽  
Double Blind ◽  
Duodenal Ulcer Healing
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