Korean J Gastroenterol.  2018 Apr;71(4):204-212. 10.4166/kjg.2018.71.4.204.

The Efficacy of Rebamipide or Ecabet Sodium Supplementation for Helicobacter pylori Eradication Therapy Compared with Quadruple (Concomitant) Regimen

• Kim J
• Kim K
• Lee JS
• Kim SY
• Kim KO
• Kim YJ
• Kwon KA
• Park DK
• Chung JW

• KMID: 2409889
• DOI: http://doi.org/10.4166/kjg.2018.71.4.204

Abstract

BACKGROUND/AIMS
Although some previous studies reported that a treatment combined with mucoprotective agent could improve the eradication rate in dual or triple therapy, there are other reports that question the efficacy of combining these drugs in concomitant therapy (CoCTx). The aim of this study was to investigate the effects of rebamipide or ecabet on the Helicobacter pylori (H. pylori) eradication combined with CoCTx.
METHODS
We retrospectively reviewed the medical records of 277 patients with proven H. pylori infection. They were assigned to one of 3 regimens for 10 days, twice daily: (a) CoCTx (n=118): lansoprazole 30 mg, amoxicillin 1 g, metronidazole 500 mg, and clarithromycin 500 mg; (b) CoCTx+rebamipide (100 mg) (n=85); (c) CoCTx+ecabet (1 g) (n=74).
RESULTS
The baseline characteristics were not significantly different. H. pylori eradication rates were 82.2% (97/118) in CoCTx, 90.6% (77/85) in CoCTx+rebamipide, and 89.2% (66/74) in CoCTx+ecabet (p=0.17), which were statistically insignificant. Overall adverse events were more frequently reported in the CoCTx+rebamipide (50.6%. 43/85) and CoCTx+ecabet (44.6%, 33/74) groups than in the CoCTx (32.2%, 38/118) (p = 0.03) group. Drug compliances were not different between three groups (CoCTx: 95.8%, 113/118; CoCT+rebamipide: 92.9%, 79/85; CoCTx+ecabet 98.6%,73/74) (p=0.209). Multivariate analysis showed that the risk of eradication failure was significantly increased with decreased drug compliance (odds ratio 3.52, 95% confidence interval 1.00-12.32; p=0.05).
CONCLUSIONS
Addition of these mucoprotective agent was not superior to CoCTx alone for eradicating H. pylori infection with frequent adverse events. Rather, drug compliance is the most related factor affecting the eradication rate. Our data suggest the importance of drug compliance over the drugs used.

Keyword

Helicobacter pylori; Therapeutics; Rebamipide; Ecabet sodium

MeSH Terms

Amoxicillin
Clarithromycin
Compliance
Helicobacter pylori*
Helicobacter*
Humans
Lansoprazole
Medical Records
Metronidazole
Multivariate Analysis
Retrospective Studies
Sodium*
Amoxicillin
Clarithromycin
Metronidazole
Sodium

Figure

• 

  Fig. 1. Comparison of major outcomes among the three groups. (A) Eradication rate. (B) Adverse events. (C) Compliance.

Reference

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