Randomised controlled trial of Helicobacter pylori eradication in patients on non-steroidal anti-inflammatory drugs: HELP NSAIDs study. Helicobacter Eradication for Lesion Prevention.
Background: The effect of Helicobacter pylori in patients receiving non-steroidal anti-inflammatory drugs (NSAIDs) is unclear. We investigated the effects of H. pylori eradication in patients with current or previous peptic ulceration, dyspepsia, or both who continued to use NSAIDs.Methods: 285 pati...
| Publicado en: | Lancet Vol. 352; no. 9133; pp. 1016 - 1022 |
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| Autores principales: | , , , , , , , , , , , , , , , , , |
| Formato: | research tables/charts randomized controlled trial Journal Article |
| Publicado: |
Lancet
9/26/1998
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=107297294&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 107297294 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01406736 LAN jtl: Lancet issn: 01406736 maglogo: N pubinfo: dt: 9/26/1998 vid: 352 iid: 9133 pid: 1297 pub: Lancet place: Philadelphia, Pennsylvania artinfo: ui: 107297294 107297294 NLM9759744 1998069615 10.1016/s0140-6736(98)04206-8 NLM9759744 107297294 ppf: 1016 ppct: 6 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Randomised controlled trial of Helicobacter pylori eradication in patients on non-steroidal anti-inflammatory drugs: HELP NSAIDs study. Helicobacter Eradication for Lesion Prevention. aug: au: Hawkey CJ Tulassay Z Szczepanski L van Rensburg CJ Filipowicz-Sosnowska A Lanas A Wason CM Peacock RA Gillon KRW Hawkey, C J Tulassay, Z Szczepanski, L van Rensburg, C J Filipowicz-Sosnowska, A Lanas, A Wason, C M Peacock, R A Gillon, K R affil: Division of Gastroenterology, University Hospital, Nottingham, UK sug: subj: Helicobacter Infections Drug Therapy Antiinflammatory Agents, Non-Steroidal Therapeutic Use Helicobacter Pylori Peptic Ulcer Microbiology Dyspepsia Microbiology Peptic Ulcer Drug Therapy Antiinflammatory Agents, Non-Steroidal Adverse Effects Peptic Ulcer Complications Treatment Outcomes Control Group Adult Middle Age Aged, 80 and Over Aged Recurrence Data Analysis, Statistical Antibiotics Therapeutic Use Clinical Trials Risk Factors Human Adult: 19-44 years Middle Aged: 45-64 years Aged, 80 & over Aged: 65+ years ab: Background: The effect of Helicobacter pylori in patients receiving non-steroidal anti-inflammatory drugs (NSAIDs) is unclear. We investigated the effects of H. pylori eradication in patients with current or previous peptic ulceration, dyspepsia, or both who continued to use NSAIDs.Methods: 285 patients were randomly assigned omeprazole 20 mg, amoxycillin 1000 mg, and clarithromycin 500 mg, twice daily (n=142, H. pylori eradication treatment), or omeprazole with placebo antibiotics (n=143, controls) for 1 week. All patients received omeprazole 20 mg once daily for 3 weeks until endoscopy, and, if the ulcer was not healed, 40 mg once daily until repeat endoscopy at 8 weeks. Ulcer-free patients with mild dyspepsia continued NSAIDs but not antiulcer treatment. We investigated ulcers with endoscopy at 1, 3, and 6 months and with carbon-13-labelled urea breath test at 3 months.Findings: The estimated probability of being ulcer-free at 6 months was 0.56 (95% CI 0.47-0.65) on eradication treatment and 0.53 (0.44-0.62) on on control treatment (p=0.80). Time to treatment failure did not differ between groups for ulcers or dyspepsia alone, per-protocol analysis, or final H. pylori status. 66% (58-74) of the eradication group compared with 14% (8-20) of the control group had a final negative H. pylori result (p<0.001). Fewer baseline gastric ulcers healed among eradication-treatment patients than among controls (72 vs 100% at 8 weeks, p=0.006).Interpretation: H. pylori eradication in long-term users of NSAIDs with past or current peptic ulcer or troublesome dyspepsia led to impaired healing of gastric ulcers and did not affect the rate of peptic ulcers or dyspepsia over 6 months. pubtype: Academic Journal doctype: research tables/charts randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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