Helicobacter Infections | Second Line Therapy for the Cure of Helicobacter Pylori (H. Pylori) Infection

Helicobacter Infections research study

What is the primary objective of this study?

Proton pump inhibitors (PPIs) are mainly metabolized in the liver by CYP2C19, one of the cytochrome P450 isoenzymes, which shows a genetic polymorphism associated with enzyme activities. The most essential role of a PPI in H. pylori eradication therapy is to make antibiotics more stable and bioavailable in the stomach by raising intragastric pH to neutral levels. Most patients who have failed in the eradication of H. pylori infection by triple therapy with a PPI, amoxicillin (AMPC) and clarithromycin (CAM) at standard doses have extensive metabolizer (EM) genotypes of CYP2C19 and/or are infected with CAM-resistant strains of H. pylori. Four-times daily dosing of a PPI could achieve complete gastric acid inhibition. Dual therapy with 4-times daily dosing of a PPI and AMPC could yield sufficient re-eradication rates in patients with EM genotype of CYP2C19. Metronidazole (MNZ)-based re-eradication therapy, such as triple PPI/AMPC/MNZ therapy, also achieved high eradication rates and has been recommended as the second line therapy in Japan. But carcinogenic actions of MNZ have been unclear. The purpose of this study is to compare the re-eradication rates of H. pylori infection by the dual high-dose PPI/AMPC therapy and triple PPI/AMPC/MNZ therapy, and to validate the efficacies of these re-eradication regimens as second line eradication therapies.

Who is eligible to participate?

Inclusion Criteria: - Patients with H. pylori infection Exclusion Criteria: - Patients without H. pylori infection

Which medical condition, disease, disorder, syndrome, illness, or injury is researched?

Helicobacter Infections


Gastric Ulcer

Duodenal Ulcer

Study Interventions

Interventions can include giving participants drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available or noninvasive approaches such as surveys, education, and interviews.

Drug:rabeprazole, amoxicillin, clarithromycin, metronidazole

Study Arms

Research studies and clinical trials typically have two or more research arms. An arm is a group of people who receive the same treatment in the study.

Study Status

Unknown status

Start Date: August 2003

Completed Date:

Phase: Phase 2/Phase 3

Type: Interventional


Primary Outcome: Which treatment yields the higher re-eradication rate of H. pylori infection

Secondary Outcome: Side effects

Study sponsors, principal investigator, and references

Principal Investigator: Naohito Shirai, MD., PhD

Lead Sponsor: Hamamatsu University


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