Comparative study of safety and efficacy of omeprazole, lansoprazole, and rabeprazole in triple therapy for eradication of Helicobacter pylori in peptic ulcer patients in Indian population

Abstract

Background: Triple therapy which includes a proton pump inhibitor (PPI) along with two antimicrobials is routinely used for the eradication of Helicobacter pylori. Multiple regimens are reported using different combinations of PPIs and antimicrobials. Aims and Objectives: The current study is done to compare the efficacy and safety of three PPIs omeprazole, lansoprazole, and rabeprazole in combination with amoxicillin and tinidazole. Materials and Methods: The patients were randomly assigned to receive one of the three regimens including one of the PPI with amoxicillin and tinidazole for 2 weeks followed by respective PPI once daily for 4 weeks. Follow-up visits were done at 2 and 6 weeks of the treatment. Endoscopy was done for any decrease in size of ulcer, rapid urease test, and histopathology for clearance of H. pylori. Results: There was a significant reduction in the size of ulcer at the end of 2 weeks in all the three groups and total healing of ulcer was observed in rabeprazole group when compared to omeprazole and lansoprazole groups. H. pylori eradication as per negative urea breath test was between 85% and 94% and it was highest in rabeprazole group. Conclusion: The three drugs were safe and equally effective in eradicating H. pylori, but rabeprazole showed earlier symptomatic relief with rapid eradication rate of H. pylori in peptic ulcer disease compared to omeprazole and lansoprazole, but it was not statistically significant. Hence, rabeprazole can be recommended to be used in PPI-triple therapy for cure of H. pylori infection in Indian population for earlier relief and better cure rates.