For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
21
views
21
references
 Top references
cited by
6
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      617
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Randomized Trial Comparing Esomeprazole and Rabeprazole in First-line Eradication Therapy for Helicobacter pylori Infection based on the Serum Levels of Pepsinogens

      research-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Objective

          CYP2C19 metabolic activity influences the efficacy of Helicobacter pylori eradication therapies comprising PPIs. Rabeprazole (RPZ) and esomeprazole (EPZ) are PPIs not extensively metabolized by CYP2C19. The aim of this study was to elucidate whether or not first-line triple therapies using RPZ or EPZ are equally effective in Japanese patients with different CYP2C19 genotypes.

          Methods

          Two-hundred patients infected with H. pylori were randomized to receive one of the following regimens: amoxicillin (750 mg), clarithromycin (200 mg), and either esomeprazole (20 mg) (EAC group) or rabeprazole (10 mg) (RAC group), twice a day for one week. The CYP2C19 polymorphisms were determined by polymerase chain reaction and the serum level of pepsinogens was measured.

          Results

          The eradication rates of the EAC and RAC regimens were 79.8% (95% confidential interval: 71.7-89.0%) and 74.7% (66.0-83.4%), respectively, in a per protocol (PP) analysis (p=0.488). The eradication rates of the EAC and RAC regimens were not significantly different between patients with the homo EM genotype (p=0.999) or hetero IM or PM genotypes (p=0.286). A lower PG I/II ratio was associated with lower eradication rates (p=0.025).

          Conclusion

          Although the eradication rate was less than 80%, the EAC and RAC regimens were equally effective in each CYP2C19 genotype group. The PG I/II ratio was associated with the results of EAC and RAC therapy in this series of patients.

          Related collections

          Most cited references21

          • Record: found
          • Abstract: found
          • Article: not found

          Helicobacter pylori treatment in the era of increasing antibiotic resistance.

          David Graham, Lori Fischbach (2010)
          With few exceptions, the most commonly recommended triple Helicobacter pylori regimen (proton pump inhibitor (PPI), amoxicillin and clarithromycin) now provides unacceptably low treatment success. A review of worldwide results suggests that successful eradication using a triple regimen is not consistently observed in any population. Clinicians should use 'only use what works locally' and ignore consensus statements and society guidelines if they are not consistent with local results. Clinical trials should be result based, with the goal of identifying regimens with >90-95% success. New treatments should be only be compared with the currently locally effective treatment (>90%) or a historical untreated control (which has been shown to reliably yield 0% eradication); trials using placebos or treatments known to be inferior are with rare exceptions unethical. If a highly effective regimen is not available locally, we recommend trying a 14 day concomitant quadruple treatment regimen containing a PPI, amoxicillin, clarithromycin and a nitroimidazole; 10 day sequential treatment (PPI plus amoxicillin for 5 days followed by a PPI, clarithromycin and a nitroimidazole for 5 days); or 14 day bismuth-containing quadruple treatments. Treatments needing further evaluation include those containing furazolidone or nitazoxanide, hybrids of sequential-concomitant therapies and amoxicillin-PPI dual therapy with PPI doses such that they maintain intragastric pH >6.
          Article 0 comments Cited 295 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Guidelines for the management of Helicobacter pylori infection in Japan: 2009 revised edition.

            Yoshihiro Fukuda, Kentaro Sugano, Kazunari Murakami … (2010)
            Over the past few years, the profile of Helicobacter pylori infection has changed in Japan. In particular, the relationship between H. pylori and gastric cancer has been demonstrated more clearly. Accordingly, the committee of the Japanese Society for Helicobacter Research has revised the guidelines for diagnosis and treatment of H. pylori infection in Japan. Four meetings of guidelines preparation committee were held from July 2007 to December 2008. In the new guidelines, recommendations for treatment have been classified into five grades according to the Minds Recommendation Grades, while the level of evidence has been classified into six grades. The Japanese national health insurance system was not taken into consideration when preparing these guidelines. Helicobacter pylori eradication therapy achieved a Grade A recommendation, being useful for the treatment of gastric or duodenal ulcer, for the treatment and prevention of H. pylori-associated diseases such as gastric cancer, and for inhibiting the spread of H. pylori infection. Levels of evidence were determined for each disease associated with H. pylori infection. For the diagnosis of H. pylori infection, measurement of H. pylori antigen in the feces was added to the tests not requiring biopsy. One week of proton-pump inhibitor-based triple therapy (including amoxicillin and metronidazole) was recommended as second-line therapy after failure of first-line eradication therapy. The revised Japanese guidelines for H. pylori are based on scientific evidence and avoid the administrative restraints that applied to earlier versions.
            Article 0 comments Cited 128 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Gastric cancer screening using the serum pepsinogen test method.

              Kazumasa MIKI (2005)
              The current status of gastric cancer screening, worldwide, as well as in Japan, using the serum pepsinogen test method, was reviewed. We performed a metaanalysis of sensitivity and specificity results from 42 individual studies (27 population-based screening studies: n = 296 553 and 15 selected groups: n = 4 385). Pooled pairs of sensitivity and false-positive rates (FPr) for pepsinogen I level < or = 70 ng/ml; pepsinogen I/II ratio < or = 3, had a sensitivity of 77%/FPr27%. The positive predictive value varied between 0.77% and 1.25%, and the negative predictive value varied between 99.08% and 99.90%. Therefore, we concluded that the definition of the pepsinogen test should include the pepsinogen I/II ratio, as consistency was obtained for both the population-based studies and the selected groups for those studies that used pepsinogen I serum levels together with the pepsinogen I/II ratio for screening for gastric cancer in high-incidence regions other than Japan. Individuals testing positive for extensive atrophic gastritis by serum pepsinogen levels undergo endoscopic examination to test for the presence of gastric cancer. We should increase the efficacy and cost-effectiveness of the gastric cancer screening system, by the identification of groups, at low-risk, as well as those at high-risk, of developing gastric cancer, using a combination of assays of serum Helicobacter pylori antibody titers and the concentration of pepsinogen I and II. In conclusion, the pepsinogen test method can be used as a screening test for high-risk subjects, rather than as a tool for screening for cancer itself. I hope that this pepsinogen test method will become a world standard for gastric cancer prevention in the near future, in other countries, as well as in Japan.
              Article 0 comments Cited 73 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Journal
                Journal ID (nlm-ta): Intern Med
                Journal ID (iso-abbrev): Intern. Med
                Title: Internal Medicine
                Publisher: The Japanese Society of Internal Medicine
                ISSN (Print): 0918-2918
                ISSN (Electronic): 1349-7235
                Publication date (Print): 1 July 2017
                Volume: 56
                Issue: 13
                Pages: 1621-1627
                Affiliations
                [1 ]Department of Gastroenterology, Hirosaki University Graduate School of Medicine, Japan
                [2 ]Sawada Clinic of Internal Medicine, Japan
                [3 ]Komai Clinic of Gastroenterology and Internal Medicine, Japan
                [4 ]Sasaki Clinic of Gastroenterology and Internal Medicine, Japan
                [5 ]Chiba Clinic of Gastroenterology and Internal Medicine, Japan
                [6 ]Shinjo Clinic of Gastroenterology and Internal Medicine, Japan
                [7 ]Department of Cancer Epidemiology and Community Health, Hirosaki University Hospital, Japan
                Author notes

                Correspondence to Dr.　Tadashi Shimoyama, tsimo-hki@ 123456unim.ac.jp

                Article
                DOI: 10.2169/internalmedicine.56.7823
                PMC ID: 5519461
                PubMed ID: 28674348
                SO-VID: 06806b12-4337-40aa-8d99-f3356da8dcd0
                Copyright © Copyright © 2017 by The Japanese Society of Internal Medicine
                License:

                The Internal Medicine is an Open Access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit ( https://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 8 June 2016
                Date accepted : 23 October 2016
                Categories
                Subject: Original Article

                Keywords: helicobacter pylori,eradication,cyp2c19,pepsinogen
                Data availability:
                Keywords: helicobacter pylori, eradication, cyp2c19, pepsinogen

                Comments

                Comment on this article

                scite_

                Similar content617

                See all similar

                Cited by6

                See all cited by

                Most referenced authors314

                See all reference authors