H. pylori: adding cetraxate to triple therapy increased eradication in smokers

Clinical bottom line (level 1b)

Smokers with dyspepsia and H. pylori infection who received triple therapy and cetraxate compared with triple therapy alone had higher eradication rates (NNT = 3 at 4 weeks) .

Kamada et al: Aliment Pharmacol Ther 2000; 14 : 1089-1094

Expires January 2004

The study

Single-blinded ?concealed randomised trial with intention-to-treat
Setting: university hospital, Japan

106 patients (aged 20 to 75; mean 49, 82% male) smokers undergoing gastroscopy for dyspepsia and found to have H. pylori infection

Excluded if

Control Group: (n = 55, 52 analysed): triple therapy
Experimental Group: (n = 51, 50 analysed): triple therapy and cetraxate 600 mg for 7 days
All patients received omeprazole 20 mg, amoxicillin 1500 mg and clarithromycin 600 mg for 7 days
95% followed for 4 weeks
Outcome notes:

eradication : confirmed on histology and 13-C breath test

adverse effects : diarrhoea, headache, taste disturbance

The evidence

Outcome	Time to outcome	CER	EER	RRR (95% CI)	ARR (95% CI)	NNT (95% CI)
eradication	4 weeks	30 (54.6%)	47 (92.2%)	69% (31% to 120%)	37.6% (22.5% to 52.7%)	3 (2 to 4)
adverse effects	4 weeks	9 (16.4%)	7 (13.7%)	16% (-110% to 66%)	2.64% (-11.0% to 16.2%)	38 (NNT = 6 to infinity; NNH = 9 to infinity)

Citation

Kamada T, Haruma K, Miyoshi E, et al: cetraxate, a mucosal protective agent, combined with omeprazole, amoxicillin and clarithromycin increases the eradication rate of Helicobacter pylori in smokers. Aliment Pharmacol Ther 2000; 14 : 1089-1094

Search Terms: from ACP Journal Club other articles noted
Contributor: Chris Ball, January 2002
Reviewer:

_{Clinical Question.}

_Patient	_{smokers with H. pylori infection}
_{Intervention or Exposure}	_{cetraxate and triple therapy}
_Comparison	_{triple therapy}
_Outcome	_eradication