Treatment for Helicobacter pylori infection: an effective strategy
DOI: 10.32364/2587-6821-2024-8-5-6
N.N. Dekhnich, M.D. Kozlova, T.N. Kovalenko
Smolensk State Medical University, Smolensk, Russian Federation
An infection with Helicobacter pylori is the underlying cause of chronic gastritis, which can progress to severe gastroduodenal disease, including gastric cancer. It is recommended that screening and eradication of H. pylori be conducted prior to the development of atrophic gastritis and intestinal metaplasia to prevent gastric cancer. To date, several studies have demonstrated the efficacy of rebamipide as a drug that prevents carcinogenesis in long-term use and provides an additive effect in increasing the rate of H. pylori eradication when added to anti-Helicobacter therapy. The metabolic status involving the cytochrome P450 (CYP) 2C19 isoenzyme is considered the key factor in determining the success of standard triple therapy with proton pump inhibitors (PPIs). Rabeprazole is less dependent on the CYP2C19 genetic polymorphism of PPIs and is superior to other PPIs in eradicating H. pylori as part of standard triple therapy. The combination of rabeprazole and rebamipide in H. pylori eradication regimens is the most effective approach to achieving the highest efficacy.
Keywords: Helicobacter pylori, eradication, rabeprazole, rebamipide, gastric cancer, gastric mucosa atrophy, intestinal metaplasia.
For citation: Dekhnich N.N., Kozlova M.D., Kovalenko T.N. Treatment for Helicobacter pylori infection: an effective strategy. Russian Medical Inquiry. 2024;8(5):281–286 (in Russ.). DOI: 10.32364/2587-6821-2024-8-5-6.
ABOUT THE AUTHORS:
Natalya N. Dekhnich — Dr. Sc. (Med.), Associate Professor, professor of the Department of Faculty Therapy, Vice-Rector for Additional Professional Education and Regional Health Development, Smolensk State Medical University; 28, Krupskaya str., Smolensk, 214019, Russian Federation; ORCID iD 0000-0002-6144-3919.
Margarita D. Kozlova — assistant of the Department of Faculty Therapy, Smolensk State Medical University; 28, Krupskaya str., Smolensk, 214019, Russian Federation.
Tatyana N. Kovalenko — clinical resident of the Department of Faculty Therapy, Smolensk State Medical University; 28, Krupskaya str., Smolensk, 214019, Russian Federation; ORCID iD 0009-0003-9829-1060.
Contact information: Natalya N. Dekhnich, e-mail: n.dekhnich@mail.ru.
Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.
There is no conflict of interest.
Received 28.03.2024.
Revised 22.04.2024.
Accepted 20.05.2024.
References
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4. Liou J.M., Malfertheiner P., Lee Y.C. et al. Screening and eradication of Helicobacter pylori for gastric cancer prevention: the Taipei global consensus. Gut. 2020;69(12):2093–2112. DOI: 10.1136/gutjnl-2020-322368.
5. Коваленко Т.Н., Дехнич Н.Н., Тряпышко А.А. и др. Актуальность основных положений Тайпейского консенсуса. Эффективная фармакотерапия. 2023;19(8):66–74. DOI: 10.33978/2307-3586-2023-19-8-66-74.Kovalenko T.N., Dekhnich N.N., Tryapyshko A.A. et al. Relevance of the main provisions of the Taipei Consensus. Effektivnaya farmakoterapiya. 2023;19(8):66–74 (in Russ.). DOI: 10.33978/2307-3586-2023-19-8-66-74.
6. Маев И.В., Андреев Д.Н., Самсонов А.А., Велиев А.М. Современные схемы эрадикационной терапии инфекции Helicobacter pylori: стратегия дифференцированного применения, эффективность и безопасность. Экспериментальная и клиническая гастроэнтерология. 2017;4(140):103–110.Maev I.V., Andreev D.N., Samsonov A.A., Veliev A.M. Modern schemes of eradication therapy of infection Helicobacter pylori: strategy of differentiated application, efficiency and safety. Eksperimental'naya i klinicheskaya gastroenterologiya. 2017;4(140):103–110 (in Russ.).
7. Андреев Д.Н., Дичева Д.Т., Маев И.В. Возможности оптимизации эрадикационной терапии инфекции Helicobacter pylori в современной клинической практике. Терапевтический архив. 2017;2:76–83.Andreev D.N., Dicheva D.T., Maev I.V. Possibilities for optimization of eradication therapy for Helicobacter pylori infection in modern clinical practice. Terapevticheskiy arkhiv. 2017;2:76–83 (in Russ.). DOI: 10.17116/terarkh201789284-90.
8. Казюлин А.Н. Использование ребамипида в качестве гастропротективного и противовоспалительного препарата при лечении язвенной болезни, ассоциированной с инфекцией Helicobacter pylori. Лечебное дело. 2016;2:51–57. Kazyulin A.N. The use of rebamipide as a gastroprotective and anti-inflammatory drug in the treatment of peptic ulcer associated with Helicobacter pylori infection. Lechebnoye delo. 2016;2:51–57 (in Russ.).
9. Андреев Д.Н., Дичева Д.Т., Парцваниа-Виноградова Е.В. Использование ребамипида в рамках комплексной терапии Helicobacter pylori-ассоциированной язвенной болезни желудка и двенадцатиперстной кишки: систематизация данных литературы. Эффективная фармакотерапия. 2017;16:34–36.Andreyev D.N., Dicheva D.T., Partsvania-Vinogradova Ye.V. Rebamipide in a Combination Therapy of Helicobacter pylori-Associated Gastroduodenal Ulcer: Systematized Published Data. Effektivnaya farmakoterapiya. 2017;16:34–36 (in Russ.).
10. Arakawa T., Higuchi K., Fujiwara Y. et al. 15th anniversary of rebamipide: looking ahead to the new mechanisms and new applications. Dig Dis Sci. 2005;50 Suppl 1:S3–S11. DOI: 10.1007/s10620-005-2800-9.
11. Naito Y., Yoshikawa T. Rebamipide: a gastrointestinal protective drug with pleiotropic activities. Expert Rev Gastroenterol Hepatol. 2010;4(3):261–270. DOI: 10.1586/egh.10.25.
12. Uchida M., Tabusa F., Komatsu M. et al. Studies on 2(1H)-quinolinone derivatives as gastric antiulcer active agents. Synthesis and antiulcer activity of optically active A-amino acid derivatives of 2(1H) quinolinone and oxindole. Chem Pharm Bull (Tokyo). 1987;35(2):853–856. DOI: 10.1248/cpb.35.853.
13. Симаненков В.И., Лутаенко Е.А., Никогосян А.А. Клинико-фармакологические особенности применения ребамипида при заболеваниях желудочно-кишечного тракта: литературный обзор. Медицинский Совет. 2016;19:88–95. DOI: 10.21518/2079-701X-2016-19-88-95.Simanenkov V.I., Lutaenko E.A., Nikogosyan A.A. Clinical and pharmacological characteristics of the use of rebamipide in diseases of the gastrointestinal tract: literature review. Meditsinskiy sovet. 2016;19:88–95 (in Russ.). DOI: 10.21518/2079-701X-2016-19-88-95.
14. Suzuki T., Yoshida N., Nakabe N. et al. Prophylactic effect of rebamipide on aspirin-induced gastric lesions and disruption of tight junctional protein zonula occludens-1 distribution. J Pharmacol Sci. 2008;106(3):469–477. DOI: 10.1254/jphs.fp0071422.
15. Hashimoto K., Oshima T., Tomita T. et al. Oxidative stress induces gastric epithelial permeability through claudin-3. Biochem Biophys Res Commun. 2008;376(1):154–157. DOI: 10.1016/j.bbrc.2008.08.140.
16. Gweon T.G., Park J.H., Kim B.W. et al. Western Kyonggi Gastrointestinal Study. Additive Effects of Rebamipide Plus Proton Pump Inhibitors on the Expression of Tight Junction Proteins in a Rat Model of Gastro-Esophageal Reflux Disease. Gut Liver. 2018;12(1):46–50. DOI: 10.5009/gnl17078.
17. Tarnawski A.S., Chai J., Pai R., Chiou S.K. Rebamipide activates genes encoding angiogenic growth factors and Cox2 and stimulates angiogenesis: a key to its ulcer healing action? Dig Dis Sci. 2004;49(2):202–209. DOI: 10.1023/b:ddas.0000017439.60943.5c.
18. Han X., Jiang K., Wang B. et al. Effect of Rebamipide on the Premalignant Progression of Chronic Gastritis: A Randomized Controlled Study. Clin Drug Investig. 2015;35(10):665–673. DOI: 10.1007/s40261-015-0329-z.
19. Lee J.S., Jeon S.W., Lee H.S. et al. Rebamipide for the Improvement of Gastric Atrophy and Intestinal Metaplasia: A Prospective, Randomized, Pilot Study. Dig Dis Sci. 2022;67(6):2395–2402. DOI: 10.1007/s10620-021-07038-7.
20. Andreev D.N., Maev I.V., Dicheva D.T. Efficiency of the Inclusion of Rebamipide in the Eradication Therapy for Helicobacter pylori Infection: Meta-Analysis of Randomized Controlled Studies. J Clin Med. 2019;8(9):1498. DOI: 10.3390/jcm8091498.
21. Nishizawa T., Nishizawa Y., Yahagi N. et al. Effect of supplementation with rebamipide for Helicobacter pylori eradication therapy: a systematic review and meta-analysis. J Gastroenterol Hepatol. 2014;29(4):20–24. DOI: 10.1111/jgh.12769.
22. Андреев Д.Н., Маев И.В., Бордин Д.С. и др. Эффективность включения ребамипида в схемы эрадикационной терапии инфекции Helicobacter pylori в России: метаанализ контролируемых исследований. Consilium Medicum. 2022;24(5):333–338. DOI: 10.26442/20751753.2022.5.201863.Andreev D.N., Maev I.V., Bordin D.S. et al. Effectiveness of Rebamipide as a part of the Helicobacter pylori eradication therapy in Russia: a meta-analysis of controlled trials. Consilium Medicum. 2022;24(5):333–338 (in Russ.). DOI: 10.26442/20751753.2022.5.201863.
23. Андреев Д.Н., Маев И.В., Дичева Д.Т. и др. Эффективность и безопасность применения ребамипида в схеме тройной эрадикационной терапии инфекции Helicobacter pylori: проспективное рандомизированное сравнительное исследование. Терапевтический архив. 2018;90(8):27–32. DOI: 10.26442/terarkh201890827-32.Andreev D.N., Maev I.V., Dicheva D.T. et al. Efficacy and safety of the use of rebamipide in the scheme of triple eradication therapy of Helicobacter pylori infection: a prospective randomized comparative study. Terapevticheskiy arkhiv. 2018;90(8):27–32 (in Russ.). DOI: 10.26442/terarkh201890827-32.
24. Hayashi S., Sugiyama T., Amano K. et al. Effect of rebamipide, a novel antiulcer agent, on Helicobacter pylori adhesion to gastric epithelial cells. Antimicrob Agents Chemother. 1998;42(8):1895–1899. DOI: 10.1128/AAC.42.8.1895.
25. Scott D., Weeks D., Melchers K., Sachs G. The life and death of Helicobacter pylori. Gut. 1998;43(1):56–60. DOI: 10.1136/gut.43.2008.s56.
26. Kim J.I., Park S.H., Kim J.K. et al. The effects of nocturnal acid breakthrough on Helicobacter pylori eradication. Helicobacter. 2002;7(6):331–336. DOI: 10.1046/j.1523-5378.2002.00105.x.
27. Sugimoto M., Furuta T., Shirai N. et al. Evidence that the degree and duration of acid suppression are related to Helicobacter pylori eradication by triple therapy. Helicobacter. 2007;12(4):317–323. DOI: 10.1111/j.1523-5378.2007.00508.x.
28. Horn J. Review article: relationship between the metabolism and efficacy of proton pump inhibitors — focus on rabeprazole. Aliment Pharmacol Ther. 2004;20 Suppl 6:11–19. DOI: 10.1111/j.1365-2036.2004.02161.x.
29. Abelö A., Andersson T.B., Antonsson M. et al. Stereoselective metabolism of omeprazole by human cytochrome P450 enzymes. Drug Metab Dispos. 2000;28(8):966–972.
30. Sahara S., Sugimoto M., Uotani T. et al. Twice-daily dosing of esomeprazole effectively inhibits acid secretion in CYP2C19 rapid metabolisers compared with twice-daily omeprazole, rabeprazole or lansoprazole. Aliment Pharmacol Ther. 2013;38(9):1129–1137. DOI: 10.1111/apt.12492.
31. Marelli S., Pace F. Rabeprazole for the treatment of acid-related disorders. Expert Rev Gastroenterol Hepatol. 2012;6(4):423–435. DOI: 10.1586/egh.12.18.
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