Objective In three studies, the two most successful regimens in the MACH1 study (omeprazole-amoxycillin-clarithromycin (OAC) and omeprazole-metronidazole-clarithromycin (OMC)) were investigated further.
Design Double-blind, randomized, international, multi-centre studies with parallel groups.
Setting The studies were performed at centres in France, Germany, Ireland, Norway, Sweden and the UK (MACH2), Canada (DU-MACH) and Germany, Hungary and Poland (GU-MACH).
Participants and interventions In MACH2, the influence of omeprazole on eradication was investigated in patients with duodenal ulcers in remission, using OAC, AC, OMC and MC.
In DU-MACH and GU-MACH, eradication and relapse rates were investigated in patients with active peptic ulcers, using : OAC, OMC and omeprazole alone.
Main outcome measures Eradication of Helicobacter pylori.
In patients with active peptic ulcer, ulcer healing was also assessed.
Results In MACH 2 (n=514, intention-to-treat (ITT) analysis), the addition of omeprazole to AC increased the eradication rate from 26 to 94%. The corresponding increase for MC/OMC was from 69 to 87%. The efficacy of the AC and OAC regimens was unaffected by primary metronidazole resistance, while that of MC was halved and that of OMC reduced by 15%. Clarithromycin resistance was uncommon.
In DU-MACH and GU-MACH (n=146 and 145, ITT analysis), eradication rates were high with both regimens. (...)
Mots-clés Pascal : Ulcère, Gastroduodénal, Randomisation, Helicobacter pylori, Spirillaceae, Spirillales, Bactérie, Etude double insu, Chimiothérapie, Oméprazole, Amoxicilline, Clarithromycine, Métronidazole, Etude multicentrique, Efficacité traitement, Eradication, Schéma programme, Benzimidazole dérivé, Imidazole dérivé, Composé nitro, Appareil digestif pathologie, Estomac pathologie, Intestin pathologie, Bactériose, Infection, Antiulcéreux, Antisécrétoire, Inhibiteur enzyme, Antifongique, Antiparasitaire, Antiprotozoaire
Mots-clés Pascal anglais : Ulcer, Gastroduodenal, Randomization, Helicobacter pylori, Spirillaceae, Spirillales, Bacteria, Double blind study, Chemotherapy, Omeprazole, Amoxicillin, Clarithromycin, Metronidazole, Multicenter study, Treatment efficiency, Eradication, Program schemate, Benzimidazole derivatives, Imidazole derivatives, Nitro compound, Digestive diseases, Gastric disease, Intestinal disease, Bacteriosis, Infection, Antiulcer agent, Antisecretory agent, Enzyme inhibitor, Antifungal agent, Parasiticid, Antiprotozoal agent
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0494683
Code Inist : 002B02H. Création : 22/03/2000.