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Article: Does eradication of Helicobacter pylori impair healing of nonsteroidal anti-inflammatory drug associated bleeding peptic ulcers? A prospective randomized study

TitleDoes eradication of Helicobacter pylori impair healing of nonsteroidal anti-inflammatory drug associated bleeding peptic ulcers? A prospective randomized study
Authors
Issue Date1998
PublisherBlackwell Publishing Ltd. The Journal's web site is located at http://www.blackwellpublishing.com/journals/APT
Citation
Alimentary Pharmacology And Therapeutics, 1998, v. 12 n. 12, p. 1201-1205 How to Cite?
AbstractBackground: Despite the widely accepted view that Helicobacter pylori is the most important cause of peptic ulcer disease, recent studies have suggested that the microbe protects against nonsteroidal anti-inflammatory drug (NSAID)-associated gastroduodenal lesions and promotes ulcer healing. We investigated the effects of H. pylori eradication on the healing of NSAID-associated bleeding peptic ulcers. Methods: Chronic NSAID users presenting with peptic ulcer haemorrhage underwent endoscopy to secure haemostasis and to document H. pylori infection by rapid urease test and culture. They were prospectively randomized to receive either omeprazole (20 mg once daily) for 8 weeks or a 1-week course of triple therapy (bismuth subcitrate 120 mg, tetracycline 500 mg, metronidazole 400 mg, all given four times daily) plus omeprazole (20 mg once daily) for 8 weeks. Endoscopy was repeated after 8 weeks. Final H. pylori status was determined by a 13C-urea breath test that was performed at least 4 weeks after discontinuation of omeprazole. Results: 195 H. pylori-infected NSAID users, complicated by bleeding ulcers, were randomized to receive omeprazole alone (102) or triple therapy plus omeprazole (93). 174 patients returned for second endoscopy at 8 weeks (91 in the omeprazole group, 83 in the triple therapy group). Urea breath test was negative in 14% in the omeprazole group vs. 92% in the triple therapy group (P < 0.001). Complete ulcer healing was achieved in 88 (97%) patients in the omeprazole group and 77 (93%) in the triple therapy group (P = 0.31). On intention-to-treat analysis, ulcers were healed in 86% of the omeprazole group and 83% of the triple therapy group (P = 0.50). There was no significant difference in the healing rates of gastric or duodenal ulcers between the two groups. Conclusion: Eradication of H. pylori did not impair the healing of NSAID-associated bleeding peptic ulcers.
Persistent Identifierhttp://hdl.handle.net/10722/163346
ISSN
2015 Impact Factor: 6.32
2015 SCImago Journal Rankings: 2.833
References

 

DC FieldValueLanguage
dc.contributor.authorChan, FKLen_US
dc.contributor.authorSung, JJYen_US
dc.contributor.authorSuen, Ren_US
dc.contributor.authorLee, YTen_US
dc.contributor.authorWu, JCYen_US
dc.contributor.authorLeung, WKen_US
dc.contributor.authorChan, HLYen_US
dc.contributor.authorLai, ACWen_US
dc.contributor.authorLau, JYWen_US
dc.contributor.authorNg, EKWen_US
dc.contributor.authorChung, SCSen_US
dc.date.accessioned2012-09-05T05:30:23Z-
dc.date.available2012-09-05T05:30:23Z-
dc.date.issued1998en_US
dc.identifier.citationAlimentary Pharmacology And Therapeutics, 1998, v. 12 n. 12, p. 1201-1205en_US
dc.identifier.issn0269-2813en_US
dc.identifier.urihttp://hdl.handle.net/10722/163346-
dc.description.abstractBackground: Despite the widely accepted view that Helicobacter pylori is the most important cause of peptic ulcer disease, recent studies have suggested that the microbe protects against nonsteroidal anti-inflammatory drug (NSAID)-associated gastroduodenal lesions and promotes ulcer healing. We investigated the effects of H. pylori eradication on the healing of NSAID-associated bleeding peptic ulcers. Methods: Chronic NSAID users presenting with peptic ulcer haemorrhage underwent endoscopy to secure haemostasis and to document H. pylori infection by rapid urease test and culture. They were prospectively randomized to receive either omeprazole (20 mg once daily) for 8 weeks or a 1-week course of triple therapy (bismuth subcitrate 120 mg, tetracycline 500 mg, metronidazole 400 mg, all given four times daily) plus omeprazole (20 mg once daily) for 8 weeks. Endoscopy was repeated after 8 weeks. Final H. pylori status was determined by a 13C-urea breath test that was performed at least 4 weeks after discontinuation of omeprazole. Results: 195 H. pylori-infected NSAID users, complicated by bleeding ulcers, were randomized to receive omeprazole alone (102) or triple therapy plus omeprazole (93). 174 patients returned for second endoscopy at 8 weeks (91 in the omeprazole group, 83 in the triple therapy group). Urea breath test was negative in 14% in the omeprazole group vs. 92% in the triple therapy group (P < 0.001). Complete ulcer healing was achieved in 88 (97%) patients in the omeprazole group and 77 (93%) in the triple therapy group (P = 0.31). On intention-to-treat analysis, ulcers were healed in 86% of the omeprazole group and 83% of the triple therapy group (P = 0.50). There was no significant difference in the healing rates of gastric or duodenal ulcers between the two groups. Conclusion: Eradication of H. pylori did not impair the healing of NSAID-associated bleeding peptic ulcers.en_US
dc.languageengen_US
dc.publisherBlackwell Publishing Ltd. The Journal's web site is located at http://www.blackwellpublishing.com/journals/APTen_US
dc.relation.ispartofAlimentary Pharmacology and Therapeuticsen_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshAnti-Inflammatory Agents, Non-Steroidal - Adverse Effectsen_US
dc.subject.meshAnti-Ulcer Agents - Therapeutic Useen_US
dc.subject.meshDrug Therapy, Combination - Therapeutic Useen_US
dc.subject.meshFemaleen_US
dc.subject.meshHelicobacter Infections - Drug Therapyen_US
dc.subject.meshHelicobacter Pylori - Physiologyen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMetronidazole - Therapeutic Useen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshOmeprazole - Therapeutic Useen_US
dc.subject.meshOrganometallic Compounds - Therapeutic Useen_US
dc.subject.meshPeptic Ulcer Hemorrhage - Drug Therapyen_US
dc.subject.meshTetracycline - Therapeutic Useen_US
dc.titleDoes eradication of Helicobacter pylori impair healing of nonsteroidal anti-inflammatory drug associated bleeding peptic ulcers? A prospective randomized studyen_US
dc.typeArticleen_US
dc.identifier.emailLeung, WK:waikleung@hku.hken_US
dc.identifier.authorityLeung, WK=rp01479en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1046/j.1365-2036.1998.00434.xen_US
dc.identifier.pmid9882027-
dc.identifier.scopuseid_2-s2.0-7844241911en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-7844241911&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume12en_US
dc.identifier.issue12en_US
dc.identifier.spage1201en_US
dc.identifier.epage1205en_US
dc.publisher.placeUnited Kingdomen_US
dc.identifier.scopusauthoridChan, FKL=7202586434en_US
dc.identifier.scopusauthoridSung, JJY=24473715000en_US
dc.identifier.scopusauthoridSuen, R=18735955900en_US
dc.identifier.scopusauthoridLee, YT=35477936800en_US
dc.identifier.scopusauthoridWu, JCY=7409253910en_US
dc.identifier.scopusauthoridLeung, WK=7201504523en_US
dc.identifier.scopusauthoridChan, HLY=16038785900en_US
dc.identifier.scopusauthoridLai, ACW=7102226209en_US
dc.identifier.scopusauthoridLau, JYW=13907867100en_US
dc.identifier.scopusauthoridNg, EKW=7201647539en_US
dc.identifier.scopusauthoridChung, SCS=19642462800en_US

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