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Eradication of Helicobacter pylori infection improves levodopa action, clinical symptoms and quality of life in patients with Parkinson's disease.
PLoS One. 2014; 9(11):e112330.Plos

Abstract

BACKGROUND

Previous studies have demonstrated a higher prevalence of Helicobacter pylori (H. pylori) infection in patients with Parkinson's disease (PD) compared to controls. H. pylori infection affects levodopa absorption and its eradication significantly improves clinical response to levodopa. Here, we studied the prevalence of H. pylori infection and its eradication effects among our PD patients.

METHODS

A prospective study involving idiopathic PD patients on levodopa therapy. 13C-urea breath test (UBT) was used to detect H. pylori. UBT-positive patients were given standard eradication therapy and followed up at 6 and 12 weeks in an open label single arm design. Repeat UBT was performed at 12 weeks. The UPDRS, PD NMQ, PD NMSS and PDQ-39 were administered at baseline and post-eradication (6 and 12 weeks). Levodopa 'onset' time and ON-duration were recorded.

RESULTS

Of 82 patients recruited, 27 (32.9%) had positive UBT. H. pylori-positive patients had significantly poorer total UPDRS (p = 0.005) and PDQ39 (p<0.0001) scores compared to H. pylori-negative patients. At 12 weeks post-eradication, the mean levodopa onset time shortened by 14 minutes (p = 0.011). The mean ON duration time increased by 56 minutes at week 6 (p = 0.041) and 38 minutes at week 12 (p = 0.035). The total UPDRS scores (p<0.0001), scores for parts II (p = 0.001), III (p<0.0001) and IV (p = 0.009) were significantly better. The total PDQ-39 scores (p = 0.001) and subdomains mobility (p = 0.002), ADL (p = 0.001), emotional well being (p = 0.026) and stigma (p = 0.034) significantly improved. The PD NMSQ did not show significant improvement.

CONCLUSIONS

H. pylori eradication improved levodopa onset time, ON duration, motor severity and quality of life parameters. Screening and eradication of H. pylori is inexpensive and should be recommended in PD patients, particularly those with erratic response to levodopa.

TRIAL REGISTRATION

ClinicalTrials.gov NCT02112812.

Authors+Show Affiliations

Neurology Unit, Department of Medicine, UKM Medical Center, Kuala Lumpur, Malaysia.Neurology Unit, Department of Medicine, UKM Medical Center, Kuala Lumpur, Malaysia.Neurology Unit, Department of Medicine, UKM Medical Center, Kuala Lumpur, Malaysia.Neurology Unit, Department of Medicine, UKM Medical Center, Kuala Lumpur, Malaysia.Neurology Unit, Department of Medicine, UKM Medical Center, Kuala Lumpur, Malaysia.Department of Community Health, UKM Medical Center, Kuala Lumpur, Malaysia.Neurology Unit, Department of Medicine, UKM Medical Center, Kuala Lumpur, Malaysia.

Pub Type(s)

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

Language

eng

PubMed ID

25411976

Citation

Hashim, Hasriza, et al. "Eradication of Helicobacter Pylori Infection Improves Levodopa Action, Clinical Symptoms and Quality of Life in Patients With Parkinson's Disease." PloS One, vol. 9, no. 11, 2014, pp. e112330.
Hashim H, Azmin S, Razlan H, et al. Eradication of Helicobacter pylori infection improves levodopa action, clinical symptoms and quality of life in patients with Parkinson's disease. PLoS One. 2014;9(11):e112330.
Hashim, H., Azmin, S., Razlan, H., Yahya, N. W., Tan, H. J., Manaf, M. R., & Ibrahim, N. M. (2014). Eradication of Helicobacter pylori infection improves levodopa action, clinical symptoms and quality of life in patients with Parkinson's disease. PloS One, 9(11), e112330. https://doi.org/10.1371/journal.pone.0112330
Hashim H, et al. Eradication of Helicobacter Pylori Infection Improves Levodopa Action, Clinical Symptoms and Quality of Life in Patients With Parkinson's Disease. PLoS One. 2014;9(11):e112330. PubMed PMID: 25411976.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Eradication of Helicobacter pylori infection improves levodopa action, clinical symptoms and quality of life in patients with Parkinson's disease. AU - Hashim,Hasriza, AU - Azmin,Shahrul, AU - Razlan,Hamizah, AU - Yahya,Nafisah Wan, AU - Tan,Hui Jan, AU - Manaf,M Rizal Abdul, AU - Ibrahim,Norlinah Mohamed, Y1 - 2014/11/20/ PY - 2014/04/20/received PY - 2014/10/05/accepted PY - 2014/11/21/entrez PY - 2014/11/21/pubmed PY - 2015/12/25/medline SP - e112330 EP - e112330 JF - PloS one JO - PLoS One VL - 9 IS - 11 N2 - BACKGROUND: Previous studies have demonstrated a higher prevalence of Helicobacter pylori (H. pylori) infection in patients with Parkinson's disease (PD) compared to controls. H. pylori infection affects levodopa absorption and its eradication significantly improves clinical response to levodopa. Here, we studied the prevalence of H. pylori infection and its eradication effects among our PD patients. METHODS: A prospective study involving idiopathic PD patients on levodopa therapy. 13C-urea breath test (UBT) was used to detect H. pylori. UBT-positive patients were given standard eradication therapy and followed up at 6 and 12 weeks in an open label single arm design. Repeat UBT was performed at 12 weeks. The UPDRS, PD NMQ, PD NMSS and PDQ-39 were administered at baseline and post-eradication (6 and 12 weeks). Levodopa 'onset' time and ON-duration were recorded. RESULTS: Of 82 patients recruited, 27 (32.9%) had positive UBT. H. pylori-positive patients had significantly poorer total UPDRS (p = 0.005) and PDQ39 (p<0.0001) scores compared to H. pylori-negative patients. At 12 weeks post-eradication, the mean levodopa onset time shortened by 14 minutes (p = 0.011). The mean ON duration time increased by 56 minutes at week 6 (p = 0.041) and 38 minutes at week 12 (p = 0.035). The total UPDRS scores (p<0.0001), scores for parts II (p = 0.001), III (p<0.0001) and IV (p = 0.009) were significantly better. The total PDQ-39 scores (p = 0.001) and subdomains mobility (p = 0.002), ADL (p = 0.001), emotional well being (p = 0.026) and stigma (p = 0.034) significantly improved. The PD NMSQ did not show significant improvement. CONCLUSIONS: H. pylori eradication improved levodopa onset time, ON duration, motor severity and quality of life parameters. Screening and eradication of H. pylori is inexpensive and should be recommended in PD patients, particularly those with erratic response to levodopa. TRIAL REGISTRATION: ClinicalTrials.gov NCT02112812. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/25411976/Eradication_of_Helicobacter_pylori_infection_improves_levodopa_action_clinical_symptoms_and_quality_of_life_in_patients_with_Parkinson's_disease_ L2 - https://dx.plos.org/10.1371/journal.pone.0112330 DB - PRIME DP - Unbound Medicine ER -