Do Japanese and Swedish peptic ulcer patients respond differently to Helicobacter pylori eradication therapies and what are their histological features?

Authors / Editors

Ohlin, Bertil

Research Areas

No matching items found.

Publication Details

Output type: Journal article

Author list: Unge P, Kimura K, Sipponen P, Ekstrom P, Satoh K, Hellblom M, Ohlin B, Stubberod A, Kihira K, Yube T, Yoshida Y

Publisher: Taylor and Francis Group

Publication year: 2003

Journal: Scandinavian Journal of Gastroenterology (0036-5521)

Volume number: 38

Issue number: 5

Start page: 482

End page: 490

Number of pages: 9

ISSN: 0036-5521

eISSN: 1502-7708

Languages: English-Great Britain (EN-GB)

Unpaywall Data

Open access status: closed

Abstract

Background: As a consequence of gastric histological differences, Japanese and Swedish peptic ulcer (PU) patients may respond differently to Helicobacter pylori eradication therapies. Methods: The study was single-blind and compared four eradication therapies in Japanese and Swedish patients with healed gastric (GU) or duodenal (DU) ulcer. Swedish patients received either (a) omeprazole+clarithromycin (OC, where O = 20 mg, C = 500 mg) for 2 weeks, or triple therapy with (b) omeprazole + amoxicillin + clarithromycin (OAC-L where O = 20 mg, A = 1 g, C = 250 mg); (c) OAC-H (where O = 20 mg, A-1 g, C-500 mg); or (d) omeprazole + metronidazole + clarithromycin (OMC, where O = 20 mg, M=400 mg, C = 250 mg) for 1 week. Antibiotic doses were weight-adjusted downwards in Japanese patients. H. pylori was assessed using the urea breath test (UBT), histology and culture pre-entry, with UBT being repeated 4 and 8 weeks after stopping treatment. Histology and culture were repeated if the UBT was positive post-therapy. Results: Recruitment included 120 patients from Japan (43 GU, 61 DU, 16 GU+DU) and 120 from Sweden (119 DU, 1 GU+DU). There were 26 exclusions from a FAS analysis due to H. pylori negativity (14), no drug administration (7) or no data after visit 1 (5). Eradication rates (FAS) from Japan were (a) 63%, (b) 93%, (c) 96% or (d) 96%, and for Sweden (a) 92%, (b) 86%, (c) 93% or (d) 96%. Dual therapy was less effective in patients with gastric atrophy associated with GU disease. Tolerability was good in all treatment groups, with no serious adverse events. Conclusion: Triple therapies were safe and effective for H. pylori eradication in Japanese and Swedish peptic ulcer patients. Dual therapy was significantly less effective in the Japanese patients, half of whom had a history of GU and more abnormal histology than in the Swedish patients, all of whom had DU.

Keywords

duodenal ulcer, eradication, ethnic groups, gastric atrophy, gastric ulcer, Helicobacter pylori, treatment

Documents