Domestic Esomeprazole Versus Nexium In The Treatment Of Duodenal Ulcer And Eradication Of Helicobacter Pylori

OBJECTIVES: Esomeprazole(40mg) when taken orally has been shown to provide greater suppression of gastric acid than the standard doses of any other PPI, as measured by the value and duration of intragastric pH greater than 4. The aim of this study was to compare the effect of domestic esomeprazole and Nexium on endoscopic healing and symptom relief in duodenal ulcer patients and the efficacy of two triple therapy regimens in the eradication of Helicobacter pylori.METHODS: A randomized, double-blind,parallel-controlled study was performed in 60 patients with active duodenal ulcer. Domestic esomeprazole or Nexium 40mg was administered once daily for 4 consecutive weeks. H. pylori-positive subjects assessed by 14C -urea breath tests and urease testing of gastric biopsies pre-entry received further eradication treatment with domestic esomeprazole or Nexium 40 mg once daily in combination with tinidazole 500 mg and clarithromycin 500 mg twice daily for 7 days. H. pylori status was documented by negative 14C -urea breath tests 4 weeks later. Symptoms were noted by using a scoring system. Gastroscopic operation was performed at 2 weeks and at 4 weeks if duodenal ulcer was not healed.RESULTS: Fifty seven patients completed in the whole trial. No significant differences were found between two groups with respect to healing rates of duodenal ulcer and improvement rates of clinical symptom.The healing rates of ulcer at 2 weeks were 86.66%and 93.33%in the domestic esomeprazole and Nexium groups, and both reached to 100% at 4 weeks(P>0.05). Total eftective rates at 2 weeks were 93.33% and 100%, respectively. Improvement rates of clinical symptom at 2 weeks were 90.75±17.47% in the domestic esomeprazole group and 86.69±29.90% in Nexium group; at 4 weeks the improvement rates were 95.15±9.45%and 93.21±15.59% in two groups (P>0.05). Overall H. pylori eradication rates were 62.07% and 37.04% with domestic esomeprazole and Nexium, respectively (not significant). Both regimens were similarly well tolerated, and patient compliance was well.CONCLUSIONS: This study showed that domestic esomeprazole 40 mg once daily is as effective and well tolerated as Nexium 40 mg once daily in the treatment of duodenal ulcer and the eradication of H. pylori infection.