Efficacy of two different Helicobacter pylori eradication regimens in patients with type 2 diabetes and the effect of Helicobacter pylori eradication on dyspeptic symptoms in patients with diabetes: a randomized controlled study

• Published in: The American journal of the medical sciences Vol. 338; no. 6; p. 459
• Main Authors: Demir, Mehmet, Gokturk, Huseyin Savas, Ozturk, Nevin Akcaer, Serin, Ender, Yilmaz, Ugur
• Format: Journal Article
• Language: English
• Published: United States 01.12.2009
• Subjects: 2-Pyridinylmethylsulfinylbenzimidazoles - administration & dosage; Adult; Amoxicillin - administration & dosage; Anti-Bacterial Agents - administration & dosage; Anti-Ulcer Agents - administration & dosage; Bismuth - administration & dosage; Clarithromycin - administration & dosage; Diabetes Mellitus, Type 2 - complications; Drug Therapy, Combination; Dyspepsia - complications; Dyspepsia - drug therapy; Female; Helicobacter Infections - complications; Helicobacter Infections - drug therapy; Helicobacter pylori; Humans; Male; Middle Aged; Ranitidine - administration & dosage; Ranitidine - analogs & derivatives
• DOI: 10.1097/MAJ.0b013e3181b5d3cf

The eradication rate of Helicobacter pylori with a standard triple regimen has been reported as being lower in patients with type 2 diabetes mellitus (DM) than in those without DM. The aim of this study was to evaluate the efficacy and tolerability of 2 different H. pylori eradication regimens in patients with type 2 DM. Ninety-eight consecutive type 2 DM and 116 nondiabetic age- and sex-matched patients were enrolled in this study. Patients were randomized to receive either pantoprazole, clarithromycin, and amoxicillin (PCA) for 14 days or ranitidine-bismuth citrate, clarithromycin, and amoxicillin (RCA) for 14 days as the eradication regimen. H. pylori eradication was assessed using C14-urea breath test 6 weeks after the end of therapy. The H. pylori eradication rate with PCA regimen in patients with DM with both intention-to-treat (ITT) and per protocol (PP) analysis was 24/49 (48.9% and 62.9%) and in non-DM patients was 44/58 (75.9% and 86.7%) with ITT and 44/57 (77.2% and 88.2%) with PP analysis (P < 0.05). The H. pylori eradication rates with RCA regimen in patients with DM were 22/49 (45.9% and 59.8%) with ITT and 22/48 (45.8% and 59.9%) with PP analysis and in non-DM patients were 44/58 (75.9% and 86.7%) with ITT and 44/56 (78.6% and 89.3%) with PP analysis. These data suggest that the eradication rate of H. pylori with PCA or RCA treatment is lower in patients with type 2 diabetes than in nondiabetics and that successful eradication could decrease dyspeptic symptoms.