Effects of N-acetylcysteine on First-Line Sequential Therapy for Helicobacter pylori Infection: A Randomized Controlled Pilot Trial.
- Author:
Hyuk YOON
1
;
Dong Ho LEE
;
Eun Sun JANG
;
Jaihwan KIM
;
Cheol Min SHIN
;
Young Soo PARK
;
Jin Hyeok HWANG
;
Jin Wook KIM
;
Sook Hayng JEONG
;
Nayoung KIM
Author Information
- Publication Type:Randomized Controlled Trial ; Original Article
- Keywords: Eradication; Helicobacter pylori; N-acetylcysteine; Sequential therapy
- MeSH: Acetylcysteine*; Amoxicillin; Clarithromycin; Compliance; Helicobacter pylori*; Helicobacter*; Humans; Metronidazole; Rabeprazole
- From:Gut and Liver 2016;10(4):520-525
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: To evaluate the adjuvant effects of N-acetylcysteine (NAC) on first-line sequential therapy (SQT) for Helicobacter pylori infection. METHODS: Patients with H. pylori infections were randomly assigned to receive sequential therapy with (SQT+NAC group, n=49) or without (SQT-only group, n=50) NAC. Sequential therapy consisted of rabeprazole 20 mg and amoxicillin 1 g for the first 5 days, followed by rabeprazole 20 mg, clarithromycin 500 mg and metronidazole 500 mg for the remaining 5 days; all drugs were administered twice daily. For the SQT+NAC group, NAC 400 mg bid was added for the first 5 days of sequential therapy. H. pylori eradication was evaluated 4 weeks after the completion of therapy. RESULTS: The eradication rates by intention-to-treat analysis were 58.0% in the SQT-only group and 67.3% in the SQT+NAC group (p=0.336). The eradication rates by per-protocol analysis were 70.0% in the SQT-only group and 80.5% in the SQT+NAC group (p=0.274). Compliance was very good in both groups (SQT only/SQT+NAC groups: 95.2%/100%, p=0.494). There was no significant difference in the adverse event rates between groups (SQT-only/SQT+NAC groups: 26.2%/26.8%, p=0.947). CONCLUSIONS: The H. pylori eradication rate was numerically higher in the SQT+NAC group than in the SQT-only group. As our data did not reach statistical significance, larger trials are warranted.
