English, Article edition: Decision Analysis of Histamine H2-Receptor Antagonist Maintenance Therapy Versus Helicobacter pylori Eradication Therapy: A Randomised Controlled Trial in Patients with Continuing Pain After Duodenal Ulcer Manouche Tavakoli; Andrzej T. Prach; Mo Malek; ...

User activity

Share to:
 
Bookmark: http://trove.nla.gov.au/version/119798
Physical Description
  • article
Language
  • English

Edition details

Title
  • Decision Analysis of Histamine H2-Receptor Antagonist Maintenance Therapy Versus Helicobacter pylori Eradication Therapy: A Randomised Controlled Trial in Patients with Continuing Pain After Duodenal Ulcer
Author
  • Manouche Tavakoli
  • Andrzej T. Prach
  • Mo Malek
  • David Hopwood
  • Bernard W. Senior
  • Frank E. Murray
Physical Description
  • article
Notes
  • Background: Much has been published on the efficacy and cost effectiveness of Helicobacter pylori eradication treatment as an alternative to histamine H2-receptor antagonist maintenance treatment in peptic ulcer disease. However, most studies have analysed and emphasised H. pylori eradication rates rather than management/​control of symptoms and the associated cost savings. Although H. pylori eradication therapy is very successful in clearing the infection, dyspeptic symptoms may persist and management of these can be expensive. Objective: The aim of this study was to assess the cost implications in controlling symptoms using either H2-receptor antagonist maintenance therapy or H. pylori eradication therapy in patients with duodenal ulcer disease. Design: This was a non-blind, prospective, randomised, parallel-group study comparing maintenance H2-receptor antagonist treatment using ranitidine with H. pylori eradication therapy, with a 1-year follow-up. Setting: This was a study of outpatients from general practices in Dundee, Scotland, or the Ninewells Hospital, Dundee, gastroenterology clinic. Patients and participants: 119 patients with confirmed duodenal ulcer, free from active ulceration at study entry but positive for H. pylori infection, who were receiving maintenance H2-receptor antagonist therapy. Interventions: Patients were randomised to receive either continuing maintenance therapy with ranitidine (initially 150mg daily; 58 patients) or H. pylori eradication therapy using an omeprazole/​amoxicillin/​metronidazole regimen (or omeprazole/​clarithromycin if allergic to penicillin). Main outcome measures and results: Overall, H. pylori eradication rates were 100% per protocol and 95.1% intention-to-treat. At completion of 1 year of follow-up, 12 of the 61 (19.7%) patients successfully eradicated of H. pylori were still dependent on acid suppression for symptom relief. H. pylori eradication treatment was the least-cost strategy in managing/​controlling symptoms at 1 year (Lstg 168 vs Lstg 210 per patient; 1996 values). However, over time, post-eradication treatment costs were greater than H2-receptor antagonist therapy costs. Any potential savings were directly related to the proportion of patients needing further treatment post-eradication, the cost of endoscopy and the urea breath test. Conclusions: If dyspepsia persists long term, H. pylori eradication treatment may not be the least-cost option for patients with duodenal ulcer.
  • Pharmacoeconomics, Helicobacter-pylori-infections, Duodenal-ulcer, Randomised-controlled-trials, Ranitidine, Omeprazole, Amoxicillin, Metronidazole, Clarithromycin, Cost-minimisation, Maintenance-therapy, Calcium-carbonate.magnesium-carbonate, Antibacterials, Antiulcers
  • RePEc:wkh:phecon:v:16:y:1999:i:4:p:355-365
Language
  • English
Contributed by
OAIster

Get this edition

  • Set up My libraries

    How do I set up "My libraries"?

    In order to set up a list of libraries that you have access to, you must first login or sign up. Then set up a personal list of libraries from your profile page by clicking on your user name at the top right of any screen.

  • All (1)
  • Unknown (1)
None of your libraries hold this item.
None of your libraries hold this item.
None of your libraries hold this item.
None of your libraries hold this item.
None of your libraries hold this item.
None of your libraries hold this item.
None of your libraries hold this item.
None of your libraries hold this item.

User activity


e.g. test cricket, Perth (WA), "Parkes, Henry"

Separate different tags with a comma. To include a comma in your tag, surround the tag with double quotes.

Be the first to add a tag for this edition

Be the first to add this to a list

Comments and reviews

What are comments? Add a comment

No user comments or reviews for this version

Add a comment