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Pantoprazole versus one‐week Helicobacter pylori eradication therapy for the prevention of acute NSAID‐related gastroduodenal damage in elderly subjects
Author(s) -
Pilotto A.,
Di Mario F.,
Franceschi M.,
Leandro G.,
Battaglia G.,
Germanà B.,
Marin R.,
Valerio G.
Publication year - 2000
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.2000.00804.x
Subject(s) - medicine , pantoprazole , helicobacter pylori , gastroenterology , omeprazole , gastroduodenal ulcer , spirillaceae , helicobacter infections , gastritis , peptic ulcer
Aim: To compare the efficacy of pantoprazole vs. a one‐week Helicobacter pylori eradication therapy for the prevention of NSAID‐related gastroduodenal damage. Methods: Patients over 60 years old with symptoms and/or a history of ulcer who needed NSAID treatment were evaluated by endoscopy. H. pylori positive subjects who had no severe gastroduodenal lesions were randomized to take, concomitantly with NSAID therapy, either: (i) pantoprazole 40 mg daily plus amoxycillin 1 g b.d. and clarithromycin 250 mg b.d. for 1 week (35 subjects, Group PAC) or (ii) pantoprazole 40 mg daily for 1 month (34 subjects, Group P). Endoscopy was repeated after 1 month. Results: A significantly higher incidence of severe gastroduodenal damage was found in Group PAC than in Group P (29% vs. 9%, P < 0.05). The percentages of patients worsened, unchanged and improved after 1 month were, respectively: Group PAC: 46%, 46%, and 9% and Group P: 7%, 65%, and 29% ( P < 0.0008). The percentage of H. pylori ‐negative subjects was 89% in Group PAC and 52% in Group P ( P =0.0009). The incidence of gastroduodenal damage was higher in Group PAC treatment failures than in cured patients (50% vs. 25.8%, P =ns). Conclusion: One month of pantoprazole was more effective than a proton pump inhibitor‐based triple therapy in the prevention of gastroduodenal damage in elderly H. pylori ‐positive NSAID users.