This open-label, prospective, randomized-controlled trial was carried out to assess if rabeprazole + amoxicillin or furazolidone regimens can be used as first-line therapy for Helicobacter pylori (H. pylori) elimination, and also investigated the factors that impact the curing rate.

In this single-center study, 292 naive people were randomly treated with bismuth-containing quadruple therapy (BQT), rabeprazole + amoxicillin dual therapy (RADT), or rabeprazole + furazolidone dual therapy (RFDT) groups. Using the 13C-urea breath test, H. pylori diagnosis and elimination were assessed.

In the per-protocol (PP) and intention-to-treat (ITT) analysis, the percentage of people in which H. pylori was eliminated, is shown in Table 1:

Noninferiority was reported between RADT and BQT groups. Compared to the RADT group, the BQT group displayed a substantially increased occurrence of adverse effects. Successful H. pylori elimination was linked with reduced body surface area and low body mass index in the BQT group. High body surface area index and smoking led to a reduction in H. pylori elimination rate in the RADT group.

In H. pylori patients, rabeprazole-amoxicillin dual therapy has similar efficacy when compared to bismuth-containing quadruple therapy. Successful elimination of H. pylori is also related to the non-smoking condition and low body surface area, that deserves future stratified assessment for optimization and refinement.