Gut Liver.  2016 Jul;10(4):520-525. 10.5009/gnl15048.

Effects of N-acetylcysteine on First-Line Sequential Therapy for Helicobacter pylori Infection: A Randomized Controlled Pilot Trial

• Yoon H
• Lee DH
• Jang ES
• Kim J
• Shin CM
• Park YS
• Hwang JH
• Kim JW
• Jeong SH
• Kim N

• KMID: 2412038
• DOI: http://doi.org/10.5009/gnl15048

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.

Keyword

Eradication; Helicobacter pylori; N-acetylcysteine; Sequential therapy

MeSH Terms

Acetylcysteine/*administration & dosage
Aged
Amoxicillin/administration & dosage
Anti-Bacterial Agents/*administration & dosage
Clarithromycin/administration & dosage
Drug Administration Schedule
Drug Therapy, Combination
Female
Helicobacter Infections/*drug therapy/microbiology
*Helicobacter pylori
Humans
Intention to Treat Analysis
Male
Metronidazole/administration & dosage
Middle Aged
Pilot Projects
Rabeprazole/administration & dosage
Treatment Outcome
Anti-Bacterial Agents
Metronidazole
Rabeprazole
Amoxicillin
Clarithromycin
Acetylcysteine