TY - JOUR
T1 - Eradication of Helicobacter pylori does not reduce the incidence of gastroduodenal ulcers in patients on long-term NSAID treatment
T2 - Double-blind, randomized, placebo-controlled trial
AU - De Leest, Helena T.J.I.
AU - Steen, Kirsti S.S.
AU - Lems, Willem F.
AU - Bijlsma, Johannes W.J.
AU - Van De Laar, Mart A.F.J.
AU - Huisman, A. Margriet
AU - Vonkeman, Harald E.
AU - Houben, Harry H.M.L.
AU - Kadir, Sylvana W.
AU - Kostense, Piet J.
AU - Van Tulder, Maurits W.
AU - Kuipers, Ernst J.
AU - Boers, Maarten
AU - Dijkmans, Ben A.C.
PY - 2007/10
Y1 - 2007/10
N2 - Background: Helicobacter pylori and nonsteroidal antiinflammatory drugs (NSAIDs) are the major causes of gastroduodenal ulcers. Studies on the benefit of eradication of H. pylori in NSAID users yielded conflicting results. Objective: To investigate whether H. pylori eradication in patients on long-term NSAIDs reduces the incidence of gastroduodenal ulcers. Methods: Patients on long-term NSAID treatment and who are H. pylori positive on serologic testing, were randomly assigned to either H. pylori eradication (omeprazole, amoxicillin, and clarithromycin) or placebo. Primary endpoint was the presence of endoscopic gastric or duodenal ulcers 3 months after randomization. Results: One hundred sixty-five (48%) of a total of 347 patients were on gastroprotective medication. At endoscopy, gastroduodenal ulcers were diagnosed in 6 (4%) and 8 (5%) patients in the eradication and placebo group, respectively (p =.65). During follow-up of 12 months, no symptomatic ulcers or ulcer complications developed. No significant differences were found in the development of gastroduodenal erosions, dyspepsia, or in quality of life. Conclusion: H. pylori eradication therapy in patients on long-term NSAID treatment had no beneficial effect on the occurrence of ulcers, erosions, or dyspepsia. Ulcer rates in both study arms are remarkably low, in both patients with and without gastroprotective therapy.
AB - Background: Helicobacter pylori and nonsteroidal antiinflammatory drugs (NSAIDs) are the major causes of gastroduodenal ulcers. Studies on the benefit of eradication of H. pylori in NSAID users yielded conflicting results. Objective: To investigate whether H. pylori eradication in patients on long-term NSAIDs reduces the incidence of gastroduodenal ulcers. Methods: Patients on long-term NSAID treatment and who are H. pylori positive on serologic testing, were randomly assigned to either H. pylori eradication (omeprazole, amoxicillin, and clarithromycin) or placebo. Primary endpoint was the presence of endoscopic gastric or duodenal ulcers 3 months after randomization. Results: One hundred sixty-five (48%) of a total of 347 patients were on gastroprotective medication. At endoscopy, gastroduodenal ulcers were diagnosed in 6 (4%) and 8 (5%) patients in the eradication and placebo group, respectively (p =.65). During follow-up of 12 months, no symptomatic ulcers or ulcer complications developed. No significant differences were found in the development of gastroduodenal erosions, dyspepsia, or in quality of life. Conclusion: H. pylori eradication therapy in patients on long-term NSAID treatment had no beneficial effect on the occurrence of ulcers, erosions, or dyspepsia. Ulcer rates in both study arms are remarkably low, in both patients with and without gastroprotective therapy.
KW - Anti-inflammatory agents
KW - Anti-ulcer agents
KW - Duodenal ulcer
KW - Helicobacter pylori
KW - Non-steroidal
KW - Stomach ulcer
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U2 - 10.1111/j.1523-5378.2007.00543.x
DO - 10.1111/j.1523-5378.2007.00543.x
M3 - Article
C2 - 17760715
AN - SCOPUS:34548186716
SN - 1083-4389
VL - 12
SP - 477
EP - 485
JO - Helicobacter
JF - Helicobacter
IS - 5
ER -
