TO COMPARE THE SAFETY AND EFFICACY OF THREE DIFFERENT, PROTON PUMP INHIBITORS OMEPRAZOLE, ESOMEPRAZOLE AND RABEPRAZOLE IN A TRIPLE DRUG REGIMEN IN PATIENTS WITH PEPTIC ULCER DISEASE IN THE ERADICATION OF H. PYLORI INFECTION

Abstract

Margaret Viola J1, Souris Kondaveti2

Peptic ulcer disease continues to be issue especially due to its high prevalence in the developing world. Helicobacter pylori (H. pylori) infection associated duodenal ulcers should undergo eradication therapy. There are many regimens offered for H. pylori eradication which include triple, quadruple, or sequential therapy regimens. In our study we planned to see whether these differences in pharmacokinetic properties show any difference in the efficacy and safety parameters between treatment with omeprazole rabeprazole and esomeprazole in the triple drug regimen for eradication of H.pylori infection in peptic ulcer patients in our hospital Osmania General Hospital / Osmania Medical College, Hyderabad.

MATERIALS AND METHODS: A total number of 45 patients were enrolled in the study. Patients with either sex suffering from peptic ulcer defined as ulcer crater of >2.5mm in size by endoscopy. Study Design: It was a randomized double blind, parallel and comparative study.

CONCLUSION: Two weeks after triple drug treatment, H.pylori was negative in 66.7%, 73% and 80% and Rapid urease test was negative in 53%, 60% and 66% in group A, B and C respectively. Endoscopy findings showed significant reduction in size and healing of ulcers in group A, B and C. There was improvement in signs and symptoms by 53 to 80%, after 2 weeks. Hence after therapy with triple drug regimen H.pylori eradication was 66-80% and healing of ulcers was 83–100% which was higher in Rabeprazole group. At 6 weeks, there was complete relief of signs and symptoms. At the follow up of 10 weeks there was no ulcer recurrence. No adverse effects were noted in all the groups. In conclusion, Triple drug regimen had shown to eradicate H.pylori infection in the treatment of Peptic ulcer. There was healing of ulcers in all the groups which was highly significant. There was no recurrence of peptic ulcer with these regimens in all the groups. However Rabeprazole group patients became asymptomatic rapidly than other groups with better H.pylori eradication.

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