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Eradication of Helicobacter pylori does not reduce the incidence of gastroduodenal ulcers in patients on long-term NSAID treatment: double-blind, randomized, placebo-controlled trial.
Helicobacter. 2007 Oct; 12(5):477-85.H

Abstract

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.

Authors+Show Affiliations

Department of Rheumatology, VU University Medical Center, Amsterdam, The Netherlands. m.deleest@vumc.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17760715

Citation

de Leest, Helena T J I., et al. "Eradication of Helicobacter Pylori Does Not Reduce the Incidence of Gastroduodenal Ulcers in Patients On Long-term NSAID Treatment: Double-blind, Randomized, Placebo-controlled Trial." Helicobacter, vol. 12, no. 5, 2007, pp. 477-85.
de Leest HT, Steen KS, Lems WF, et al. Eradication of Helicobacter pylori does not reduce the incidence of gastroduodenal ulcers in patients on long-term NSAID treatment: double-blind, randomized, placebo-controlled trial. Helicobacter. 2007;12(5):477-85.
de Leest, H. T., Steen, K. S., Lems, W. F., Bijlsma, J. W., van de Laar, M. A., Huisman, A. M., Vonkeman, H. E., Houben, H. H., Kadir, S. W., Kostense, P. J., van Tulder, M. W., Kuipers, E. J., Boers, M., & Dijkmans, B. A. (2007). Eradication of Helicobacter pylori does not reduce the incidence of gastroduodenal ulcers in patients on long-term NSAID treatment: double-blind, randomized, placebo-controlled trial. Helicobacter, 12(5), 477-85.
de Leest HT, et al. Eradication of Helicobacter Pylori Does Not Reduce the Incidence of Gastroduodenal Ulcers in Patients On Long-term NSAID Treatment: Double-blind, Randomized, Placebo-controlled Trial. Helicobacter. 2007;12(5):477-85. PubMed PMID: 17760715.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Eradication of Helicobacter pylori does not reduce the incidence of gastroduodenal ulcers in patients on long-term NSAID treatment: 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 - 2007/9/1/pubmed PY - 2007/11/2/medline PY - 2007/9/1/entrez SP - 477 EP - 85 JF - Helicobacter JO - Helicobacter VL - 12 IS - 5 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. SN - 1083-4389 UR - https://www.unboundmedicine.com/medline/citation/17760715/Eradication_of_Helicobacter_pylori_does_not_reduce_the_incidence_of_gastroduodenal_ulcers_in_patients_on_long_term_NSAID_treatment:_double_blind_randomized_placebo_controlled_trial_ L2 - https://doi.org/10.1111/j.1523-5378.2007.00543.x DB - PRIME DP - Unbound Medicine ER -