Esomeprasol in the treatment of duodenal ulcer under various regimens of antihelicobacter therapy

Aim. To assess efficiency of esomeprazole in the treatment of duodenal ulcer (DU) associated with Hpylori in various eradication regimens. Material and methods. 80 patients with duodenal ulcer at least 0.5 cm in diameter were randomized into three groups. 23 patients of group 1, 28 patients of group 2 received esomeprazole for 7 days in a dose 20 mg twice a day, in a single morning dose 40 mg, respectively. 29 patients of group 3 received omeprazole 20 mg twice a day for 7 days and further 3 weeks 20 mg twice a day. All the patients were also given amoxicillin 1000 mg twice a day and clarithromycin 500 mg twice a day for a week. Results. An antisecretory effect of esomeprazole as shown by 24-h monitoring of gastric secretion was longer and more stable than that of omeprazole: a latent period averaged 1.5 ± 0.6 h in a pharmacological test with 20 mg esomeprazole, 1.2 ± 0.4 h in intake of 40 mg esomeprazole and 2.1 + 0.3 h in intake of 20 mg omeprazole. Overall duration of the antisecretory effect averaged 16.8 ± 1.9, 20.3 ±1.7 and 12.5 ± 1.9 h, respectively. The time of intragastric pH > 4 was 13.1 ± 1.6, 2 ± 1.6 and 9.8 ± 1.5 hours, respectively. Eradication of H.pylori in group 1, 2 and 3 was 91.3, 3 and 89.6%, respectively. Complete epithelization of ulcer occurred in 95.6, 92.8 and 93.1% cases, respectively. In 77 patients who finished the treatment according to the protocol the treatment resulted in eradication in 95.6, 92.5 and 92.8%, respectively; in epithelization - in 100, 96.3 and 96.4% patients of groups 1, 2 and 3, respectively. Side effects were mild or moderate but not causing changes of the regimen or treatment discontinuation. Conclusion. Esomeprazole in three-component treatment was highly effective in eradication of H. pylori and epithelisation of duodenal ulcer defects in various regimens of administration. Esomeprazole in combination with amoxicillin and clarithromycin reduces the time of treatment of DU associated with H. pylori to 1 week without further monotherapy with antisecretory drugs.