2.Additive Effect of Pronase on the Eradication Rate of First-Line Therapy for Helicobacter pylori Infection.
Chang Seok BANG ; Yeon Soo KIM ; Sang Hyun PARK ; Jin Bong KIM ; Gwang Ho BAIK ; Ki Tae SUK ; Jai Hoon YOON ; Dong Joon KIM
Gut and Liver 2015;9(3):340-345
BACKGROUND/AIMS: Helicobacter pylori colonizes on the apical surface of gastric surface mucosal cells and the surface mucous gel layer. Pronase is a premedication enzyme for endoscopy that can disrupt the gastric mucus layer. We evaluated the additive effects of pronase combined with standard triple therapy for H. pylori eradication. METHODS: This prospective, single-blinded, randomized, controlled study was conducted between June and October 2012. A total of 116 patients with H. pylori infection were enrolled in the study (n=112 patients, excluding four patients who failed to meet the inclusion criteria) and were assigned to receive either the standard triple therapy, which consists of a proton pump inhibitor with amoxicillin and clarithromycin twice a day for 7 days (PAC), or pronase (20,000 tyrosine units) combined with the standard triple therapy twice a day for 7 days (PACE). RESULTS: In the intention-to-treat analysis, the eradication rates of PAC versus PACE were 76.4% versus 56.1% (p=0.029). In the per-protocol analysis, the eradication rates were 87.5% versus 68.1% (p=0.027). There were no significant differences concerning adverse reactions between the two groups. CONCLUSIONS: According to the interim analysis of the trial, pronase does not have an additive effect on the eradication of H. pylori infection (ClinicalTrial.gov: NCT01645761).
Adult
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Amoxicillin/therapeutic use
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Anti-Bacterial Agents/*therapeutic use
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Clarithromycin/therapeutic use
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Drug Administration Schedule
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Drug Therapy, Combination/methods
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Female
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Gastric Mucosa/drug effects/microbiology
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Helicobacter Infections/*drug therapy
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Helicobacter pylori/*drug effects
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Humans
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Male
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Middle Aged
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Pronase/*therapeutic use
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Prospective Studies
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Proton Pump Inhibitors/*therapeutic use
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Single-Blind Method
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Treatment Outcome