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Magaldrate granules combined with rabeprazole, amoxicillin, and clarithromycin achieve H. pylori eradication rates comparable to standard bismuth quadruple therapy, while providing greater early relief of epigastric pain.
A multicenter prospective study from China finds that magaldrate granule-based quadruple therapy provides effective and well-tolerated eradication of Helicobacter pylori (H. pylori, Hp) in patients with newly diagnosed infection and chronic gastritis.
Current first-line Hp eradication strategies are highly effective but are frequently associated with gastrointestinal discomfort and treatment-related adverse effects that may affect patient experience. Magaldrate, with its gastric mucosal protective and acid-neutralizing properties, has emerged as a potential alternative component of eradication therapy, prompting investigators to evaluate whether it could maintain eradication efficacy while improving symptom control.
To explore this possibility, they conducted a prospective, randomized, multicenter trial involving 557 patients with newly diagnosed Hp-associated chronic gastritis. Volunteers were allocated using a random number table to:
Treatment success was evaluated using both full analysis set (FAS) and per-protocol set (PPS) populations, alongside assessments of early symptom relief and treatment-emergent adverse events. The findings, as demonstrated in Table 1, revealed that both magaldrate-based regimens met non-inferiority criteria for Hp eradication when compared with standard bismuth therapy. Beyond eradication, patients receiving magaldrate experienced more rapid improvement in epigastric pain during the early treatment period, suggesting an additional symptomatic benefit.
Importantly, treatment-emergent adverse events including dizziness, nausea, vomiting, abdominal pain, diarrhea, and rash occurred at comparable frequencies across all three treatment groups, indicating that the improved symptom relief was not accompanied by an increased safety burden.
By combining equivalent eradication efficacy, earlier symptom resolution, and a safety profile similar to conventional bismuth therapy, magaldrate-based quadruple therapy represents a promising first-line option for patients with Hp-associated chronic gastritis, particularly when rapid symptom control is a clinical priority.
Zhonghua Yi Xue Za Zhi
[Analysis of the efficacy and safety of magaldrate granules quadruple therapy in the treatment of Helicobacter pylori infection]
X H Dong et al.
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