Turkish Journal of Gastroenterology
Original Article

Effect of pantoprazole and Helicobacter pylori therapy on uninvestigated dyspeptic patients

1.

Department of Gastroenterology, Bezmialem Vakif University Faculty of Medicine, İstanbul, Turkey

2.

Department of Biostatistics, Bezmialem Vakif University Faculty of Medicine, İstanbul, Turkey

Turk J Gastroenterol 2015; 26: 6-14
DOI: 10.5152/tjg.2015.0010
Read: 2390 Downloads: 989 Published: 25 July 2019

Abstract

Background/Aims: This study aimed to test the efficacy of empirical proton pump inhibitor use and Helicobacter pylori therapy for uninvestigated dyspepsia in a population with a high prevalence of H. pylori.

 

Material and Methods: The study had a two-stage design. In the first stage, the efficacy of 4-week pantoprazole treatment was compared with placebo in patients with uninvestigated dyspepsia. In the second stage, the efficacies of 2-week treatment with pantoprazole in H. pylori-negative patients and H. pylori eradication therapy (pantoprazole + amoxicillin + clarithromycin) in H. pylori-positive patients were compared. The primary endpoint was sufficient overall symptom relief (Global Overall Symptom score ≤2; no or minimal symptoms) at the end of treatment.

 

Results: In the first stage, sufficient overall symptom relief was achieved by 25.2% of patients in the pantoprazole group and 15.5% of patients in the placebo group, a difference that was not statistically significant (p=0.06). In the second stage, the rate of sufficient overall symptom relief was higher in the H. pylori therapy group than in the pantoprazole group (37.1% vs. 23.4%; p=0.02). After untreated follow-up, sufficient overall symptom relief remained significantly higher in the H. pylori therapy group than in the pantoprazole group (39.7% vs. 18%; p<0.001). Almost all patients receiving pantoprazole experienced symptom relapse after treatment.

 

 

Conclusions: This study validated the use of a test-and-treat strategy against H. pylori in uninvestigated dyspepsia, which may be an advisable treatment approach for uninvestigated dyspeptic patients in countries with a high prevalence of H. pylori. 

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