Læknablaðið : fylgirit - 01.06.1998, Blaðsíða 54

48
LÆKNABLAÐIÐ 1998; 84/FYLGIRIT 36
Observed H. pylori eradication rates were det-
ermined for all patients with post-treatment H.
pylori tests evaluable for both visits. ITT (intention
to treat) (one test) and ITT (two test) rates were
determined for all H. pylori positive patients
treated who had at least one follow-up visit or tvo
follow-up visits, respectively. In the ITT analysis
missing or early negative results were treated as
failures. All analysis treated positive UBTs at any
time post-treatment as failures.
Kesults: Demography was comparable for the
two treatment groups.
Conclusions: RBC 400 mg b.i.d. with Clar 500
mg b.i.d. given for seven days or for 14 days effect-
ively eradicated H. pylori. Both regimens were
well tolerated. RBC 400-mg b.i.d. with Clar 500-
mg b.i.d. for seven days is a simple effective and
well-tolerated therapy for H. pylori eradication.
E-50. High Helicobacter pylori erad-
ication rate with a one week regimen
containing ranitidine bismuth citrate
Hallgrímur Guðjónssoit*, Bjarni Þjóðleifsson*,
Einar Oddsson*, Kjartan B. Örvar**, Hjörleifur
Þórarinsson***, Duggan AE*'***
Frá *Landspítalanum, **St. Jósefsspítala Hafnar-
firði, ***GlaxoWeUcome hf, ****GlaxoWellcome
Research & Development, Uxbridge
Introduction: High Helicobacter pylori erad-
ication rates have consistently been reported with
two weeks dual therapy regimens of ranitidine bis-
muth citrate plus clarithromycin. Ranitidine bis-
muth citrate with two antibiotics may provide an
alternative one week eradication regimen.
Material and methods: This double-blind,
randomised, parallel group, international,
multicenter study compared ranitidine bismuth
citrate 400 mg bd and clarithromycin 500 mg bd for
two weeks (RC) with ranitidine bismuth citrate 400
mg bd, clarithromycin 500 mg bd and metronid-
azole 400 mg bd for one week (RCM) for erad-
ication of H. pylori infection in 350 patients with
dyspepsia.
Results: Observed H. pylori eradication rates
(confirmed by two discrete negative l3C-urea breath
tests at nominal weeks four and 12) were 89%
(95% 0:88-95%) with RC and 92% (95% Cl: 88-
97%) with RCM. Both regimens were well tolerat-
ed with only 6% of patients given RC and 4% given
RCM discontinuing treatment due to an adverse
event. Median plasma bismuth concentrations mea-
sured at the end of the second week of study were
low, being 3.5 and 0.4 ng/ml with RC and RCM,
respectively.
Conclusions:
Ranitidine bismuth
citrate triple therapy
for one week (RCM)
and dual therapy for
two weeks (RC) were
both highly effective
for eradication of H.
pylori infection.
E-51. Helicobacter
sýking veitir
vernd gegn skainmtíma NSAIDs áverka
á magaslímhúö
Bjarni Þjóðleifsson*, Einar Oddsson*, Hafdís
Aradóttir*, Hallgrímur Guðjónsson*, Herdís Ast-
ráðsdóttir*, Ingvar Bjarnason**, Ashley Price**
Frá *rannsóknastofu í meltingarsjúkdómum Land-
spítalanum, **Kings College Hospital London
Inngangur: Averki NSAIDs lyfja á magaslím-
húð er fyrst og fremst talinn stafa af skorti á
prostaglandinum vegna blokkunar á cyclooxy-
genasa. Helicobacter sýking veldur mikilli bólgu-
frumuíferð og aukinni prostaglandinmyndun í
magaslímhúð. Tilgangur rannsóknarinnar var að
skoða hvort Helicobacter verndar gegn NSAIDs
áverka.
Efniviður og aðferðir: Rannsóknin var með tví-
blindu krossuðu sniði. Naproxen var gefið 500 mg
x 2 og nimesúlíð 100 mg x 2 í 14 daga með 14 daga
hléi á milli. Þátttakendur voru 23 heilbrigðir ein-
staklingar, 12 karlar og 11 konur á aldrinum 45-65
ára. Áverki á maga og skeifugörn var metinn með
magaspeglun á meðferðardögum 0 og 14. Slímhúð-
arbreytingar (roði, blæðingar, fleiður og sár) voru
mældar með „visual analogue scale“ (VAS) 0-150
mm. Tvö sýni voru tekin í antrum og corpus til
vefjaskoðunar og eitt sýni í antrum fyrir CLO próf
(rapid urease test) fyrir Helicobacter. Vefjasýnin
voru ilokkuð af Ashley Price án vitundar um lyfja-
gjöf samkvæmt Sydney skilmerkjum, sem greinir
langvinna og bráða bólgu á kvarða 0-20.
Niðurstöður: Helicobacter greindist hjá 12 ein-
H. pylori eradication % (95% CI) (n/N). RBC+Clar 7 days RBC+Clar 14 days
Observed (two test) 83% (77-89)1135/163] 83% (78-89)[ 135/162]
ITT (one test) 80% (74-86)[141/176] 80% (74-86)[142/178]
ITT (two test) 77% (71-83)[135/176] 76% (70-82)[135/178]
% of patients with AEs 33% [58/178] 34% [62/182]
% of patients with-
drawn due to AEs 1% 12/1781 5% 110/1821
ITT=intention to treat
AE=adverse events