Rabeprazole‐ versus Esomeprazole‐Based Eradication Regimens for H. pylori Infection

Abstract Background: Different kinds of proton pump inhibitor‐based triple therapies could result in different Helicobacter pylori eradication rates. Aim: The aims of this study were to compare the efficacy and safety of rabeprazole‐ and esomeprazole‐based triple therapy in primary treatment of H. pylori infection in Taiwan. Patients and Methods: From June 2005 to March 2007, 420 H. pylori ‐infected patients were randomly assigned to receive a 7‐day eradication therapy with either esomeprazole 40 mg daily (EAC group, n = 209) or rabeprazole 20 mg b.i.d. (RAC group, n = 211) in combination with amoxicillin 1 g b.i.d. and clarithromycin 500 mg b.i.d.. Follow‐up endoscopy with biopsy was done 12–16 weeks after completion of eradication therapy. Those who refused endoscopic exams underwent 13 C‐urea breath test to assess the treatment response. Results: Intention‐to‐treat analysis revealed that the eradication rate was 89.4% in the EAC group and 90.5% in RAC groups ( p ‐value = .72). All of the subjects returned for assessment of compliance (100% in EAC group vs. 99.5% in RAC group, p ‐value = .32) and adverse events (3.83% in EAC group vs. 6.16% in RAC group, p ‐value = .27). Sixty (28.7%) and 37 (17.6%) patients in EAC and RAC group, respectively, refused endoscopy and underwent a 13 C‐urea breath test to determine the treatment effect. Conclusion: In conclusion, rabeprazole‐ and esomeprazole‐based primary therapies for H. pylori infection are comparable in efficacy and safety.