H.Pylori Infection Clinical Trial
Official title:
Effect of Treatment With REbamipide for Helicobacter Pylori Eradication Therapy
the primary aim is specially in resistant cases of H.pylori and in promotion of peptic ulcer
Helicobacter pylori infection is the main cause of peptic ulcer (1, 2) Some consensus
conferences have recommended triple therapy with a proton pump inhibitor (PPI) and two types
of antibiotics for 7 days as first-line treatment when patients with peptic ulcer have
Helicobacter pylori infection.(3, 4)This recommendation is based on the finding that patients
with proven eradication of H. pylori have an extremely low rate of recurrence of peptic
ulcer.(5) Although a well-controlled study found comparable rates of small gastric ulcer
healing after eradication therapy alone without continuation of antiulcer treatment, relief
of symptoms was significantly slower with eradication therapy alone. Moreover, the success
rate of eradication therapy has decreased during the past few decades, and whether or not
eradication is successful becomes clear only 2-4 weeks after treatment(6).
Patients with large gastric ulcer lesions are often not completely healed with H. pylori
eradication alone (7) . Proton pump inhibitors (PPIs) have become the mainstay of maintenance
therapy after eradication of H. pylori infection due to the associated effective healing and
fast relief of symptoms without tachyphylaxis. However, PPI therapy has some risks, including
dyspeptic symptom or rebound acid hypersecretion after cessation that may induce dependence
(8,9) , drug interactions with other substrate of CYP2C19, and some kinds of respiratory or
gastrointestinal infections . Also, the result of H. pylori eradication can be affected by
such antisecretory drugs.(10) Rebamipide is a gastroprotective antiulcer drug that has been
found to reduce the rate of recurrence of gastric ulcers without affecting H. pylori status,
unlike antisecretory drugs such as PPIs and H2 receptor antagonists.6 and have a healing rate
of about 90% at 8 weeks after eradication therapy (11) Rebamipide (2-(4-
chlorobenzoylamino)-3-[2-(1H)-quinolinon-4-yl] propionic acid) prevents gastric ulcer
formation by inhibiting neutrophil activation. Rebamipide stimulates prostaglandin generation
in the gastric mucosa, resulting in stimulation of mucus secretion. Rebamipide inhibits H.
pylori adhesion to the gastric epithelial cells.(12) The primary aim of study to evaluate
whether rebamipide could improve success rates of anti-H. pylori treatment .
;
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