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Article: Twelve-month endoscopic and histological analysis following proton-pump inhibitor-based triple therapy in Helicobacter pylori-positive patients with gastric ulcers

TitleTwelve-month endoscopic and histological analysis following proton-pump inhibitor-based triple therapy in Helicobacter pylori-positive patients with gastric ulcers
Authors
KeywordsEradication therapy
Esomeprazole
Gastric ulcer
Helicobacter pylori
Histology
Issue Date2010
PublisherInforma Healthcare. The Journal's web site is located at http://www.tandf.co.uk/journals/titles/00365521.asp
Citation
Scandinavian Journal Of Gastroenterology, 2010, v. 45 n. 9, p. 1048-1058 How to Cite?
AbstractObjective. To evaluate endoscopic and histological findings after Helicobacter pylori eradication therapy in gastric ulcer (GU) patients after 12 months' follow-up. Material and methods. A total of 401 GU patients were randomized to receive either twice-daily (b.i.d.) esomeprazole 20 mgamoxicillin 1000 mgclarithromycin 500 mg (EAC) for 1 week followed by placebo for 3 weeks, EAC followed by once-daily (o.d.) esomeprazole 20 mg for 3 weeks or esomeprazole 20 mg b.i.d. plus placebo antibiotics for 1 week followed by esomeprazole 20 mg o.d. for 3 weeks. Endoscopy with biopsy was performed at baseline, after treatment and at 6 and 12 months' follow-up (healed patients). Results. Endoscopic abnormalities, particularly in the stomach, were common at baseline and remained similar during follow-up, regardless of ulcer status and treatment. Helicobacter gastritis was present (antrum or corpus) in ≈ 20% of patients following eradication therapy (versus ≈ 80% with esomeprazole alone); these effects were sustained during follow-up. Similar trends were observed for other histological variables (granulocyte and lymphoplasmocytic cell infiltration, replacement of gastric surface cells by regenerative epithelium, and mucous depletion). No changes in atrophy or intestinal metaplasia were observed. Eighteen gastric cancer cases were detected: 11 at baseline endoscopy, and seven during treatment and follow-up. Conclusions. Endoscopic abnormalities are common in GU patients and persist after proton-pump inhibitor-based triple therapy for H. pylori eradication, which is associated with large, sustained improvements in histological variables. Follow-up endoscopy and histology may be necessary, even in patients with apparently non-malignant GU, to improve the detection rate of gastric malignancy in populations with a high prevalence of gastric cancer. © 2010 Informa Healthcare.
Persistent Identifierhttp://hdl.handle.net/10722/163330
ISSN
2023 Impact Factor: 1.6
2023 SCImago Journal Rankings: 0.669
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorTulassay, Zen_US
dc.contributor.authorStolte, Men_US
dc.contributor.authorEngstrand, Len_US
dc.contributor.authorButruk, Een_US
dc.contributor.authorMalfertheiner, Pen_US
dc.contributor.authorDt, Pen_US
dc.contributor.authorTchernev, Ken_US
dc.contributor.authorWong, BCYen_US
dc.contributor.authorGottlow, Men_US
dc.contributor.authorEklund, Sen_US
dc.contributor.authorWrangstadh, Men_US
dc.contributor.authorHerszényi, Len_US
dc.contributor.authorNagy, Pen_US
dc.date.accessioned2012-09-05T05:30:06Z-
dc.date.available2012-09-05T05:30:06Z-
dc.date.issued2010en_US
dc.identifier.citationScandinavian Journal Of Gastroenterology, 2010, v. 45 n. 9, p. 1048-1058en_US
dc.identifier.issn0036-5521en_US
dc.identifier.urihttp://hdl.handle.net/10722/163330-
dc.description.abstractObjective. To evaluate endoscopic and histological findings after Helicobacter pylori eradication therapy in gastric ulcer (GU) patients after 12 months' follow-up. Material and methods. A total of 401 GU patients were randomized to receive either twice-daily (b.i.d.) esomeprazole 20 mgamoxicillin 1000 mgclarithromycin 500 mg (EAC) for 1 week followed by placebo for 3 weeks, EAC followed by once-daily (o.d.) esomeprazole 20 mg for 3 weeks or esomeprazole 20 mg b.i.d. plus placebo antibiotics for 1 week followed by esomeprazole 20 mg o.d. for 3 weeks. Endoscopy with biopsy was performed at baseline, after treatment and at 6 and 12 months' follow-up (healed patients). Results. Endoscopic abnormalities, particularly in the stomach, were common at baseline and remained similar during follow-up, regardless of ulcer status and treatment. Helicobacter gastritis was present (antrum or corpus) in ≈ 20% of patients following eradication therapy (versus ≈ 80% with esomeprazole alone); these effects were sustained during follow-up. Similar trends were observed for other histological variables (granulocyte and lymphoplasmocytic cell infiltration, replacement of gastric surface cells by regenerative epithelium, and mucous depletion). No changes in atrophy or intestinal metaplasia were observed. Eighteen gastric cancer cases were detected: 11 at baseline endoscopy, and seven during treatment and follow-up. Conclusions. Endoscopic abnormalities are common in GU patients and persist after proton-pump inhibitor-based triple therapy for H. pylori eradication, which is associated with large, sustained improvements in histological variables. Follow-up endoscopy and histology may be necessary, even in patients with apparently non-malignant GU, to improve the detection rate of gastric malignancy in populations with a high prevalence of gastric cancer. © 2010 Informa Healthcare.en_US
dc.languageengen_US
dc.publisherInforma Healthcare. The Journal's web site is located at http://www.tandf.co.uk/journals/titles/00365521.aspen_US
dc.relation.ispartofScandinavian Journal of Gastroenterologyen_US
dc.subjectEradication therapy-
dc.subjectEsomeprazole-
dc.subjectGastric ulcer-
dc.subjectHelicobacter pylori-
dc.subjectHistology-
dc.subject.meshAmoxicillin - Pharmacology - Therapeutic Useen_US
dc.subject.meshClarithromycin - Pharmacology - Therapeutic Useen_US
dc.subject.meshFemaleen_US
dc.subject.meshHelicobacter Infections - Drug Therapy - Microbiology - Pathologyen_US
dc.subject.meshHelicobacter Pylori - Drug Effectsen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshOmeprazole - Pharmacology - Therapeutic Useen_US
dc.subject.meshProton Pump Inhibitors - Pharmacology - Therapeutic Useen_US
dc.subject.meshStomach Ulcer - Drug Therapy - Microbiology - Pathologyen_US
dc.subject.meshTreatment Outcomeen_US
dc.titleTwelve-month endoscopic and histological analysis following proton-pump inhibitor-based triple therapy in Helicobacter pylori-positive patients with gastric ulcersen_US
dc.typeArticleen_US
dc.identifier.emailWong, BCY:bcywong@hku.hken_US
dc.identifier.authorityWong, BCY=rp00429en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.3109/00365520903575737en_US
dc.identifier.pmid20509752-
dc.identifier.scopuseid_2-s2.0-77955528061en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-77955528061&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume45en_US
dc.identifier.issue9en_US
dc.identifier.spage1048en_US
dc.identifier.epage1058en_US
dc.identifier.isiWOS:000282143800007-
dc.publisher.placeUnited Kingdomen_US
dc.identifier.scopusauthoridTulassay, Z=7006796071en_US
dc.identifier.scopusauthoridStolte, M=7201690904en_US
dc.identifier.scopusauthoridEngstrand, L=7006203192en_US
dc.identifier.scopusauthoridButruk, E=7006360922en_US
dc.identifier.scopusauthoridMalfertheiner, P=36048150200en_US
dc.identifier.scopusauthoridDt, P=36337568100en_US
dc.identifier.scopusauthoridTchernev, K=25123419000en_US
dc.identifier.scopusauthoridWong, BCY=7402023340en_US
dc.identifier.scopusauthoridGottlow, M=24176468200en_US
dc.identifier.scopusauthoridEklund, S=7005489959en_US
dc.identifier.scopusauthoridWrangstadh, M=6603477875en_US
dc.identifier.scopusauthoridHerszényi, L=6701492700en_US
dc.identifier.scopusauthoridNagy, P=35746892800en_US
dc.identifier.issnl0036-5521-

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