Role of Helicobacter pylori infection and non-steroidal anti-inflammatory drugs in peptic-ulcer disease: a meta-analysis.
Background: The relation between H pylori infection and use of non-steroidal anti-inflammatory drugs (NSAIDs) in the pathogenesis of peptic-ulcer disease is controversial. We undertook a meta-analysis to address this issue.Methods: By computer and manually we sought observational studies on the prev...
| Publicado en: | Lancet Vol. 359; no. 9300; pp. 14 - 23 |
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| Autores principales: | , , |
| Formato: | research systematic review Journal Article |
| Publicado: |
Lancet
1/5/2002
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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=117181141&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 117181141 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01406736 LAN jtl: Lancet issn: 01406736 maglogo: N pubinfo: dt: 1/5/2002 vid: 359 iid: 9300 pid: 1297 pub: Lancet place: Philadelphia, Pennsylvania artinfo: ui: 117181141 117181141 NLM11809181 117181141 10.1016/s0140-6736(02)07273-2 NLM11809181 117181141 ppf: 14 ppct: 9 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Role of Helicobacter pylori infection and non-steroidal anti-inflammatory drugs in peptic-ulcer disease: a meta-analysis. aug: au: Huang, Jia Qing Sridhar, Subbaramiah Hunt, Richard H affil: Division of Gastroenterology, Department of Medicine, McMaster University Medical Center, 1200 Main Street West, Room 4W8, Ontario L8N 3Z8, Hamilton, Canada sug: subj: Peptic Ulcer Etiology Antiinflammatory Agents, Non-Steroidal Adverse Effects Peptic Ulcer Chemically Induced Helicobacter Pylori Helicobacter Infections Complications Helicobacter Infections Epidemiology Female Human Case Control Studies Peptic Ulcer Epidemiology Aged Prevalence Risk Factors Adult Male Middle Age Meta Analysis Systematic Review Odds Ratio Confidence Intervals Aged: 65+ years Adult: 19-44 years Middle Aged: 45-64 years Female Male ab: Background: The relation between H pylori infection and use of non-steroidal anti-inflammatory drugs (NSAIDs) in the pathogenesis of peptic-ulcer disease is controversial. We undertook a meta-analysis to address this issue.Methods: By computer and manually we sought observational studies on the prevalence of peptic-ulcer disease in adult NSAID takers or the prevalence of H pylori infection and NSAID use in patients with peptic-ulcer bleeding. Summary odds ratios were calculated from the raw data. Tests for homogeneity were done.Findings: Of 463 citations identified, 25 studies met inclusion criteria. In 16 studies of 1625 NSAID takers, uncomplicated peptic-ulcer disease was significantly more common in patients positive than in those negative for H pylori (341/817 [41.7%] vs 209/808 [25.9%]; odds ratio 2.12 [95% CI 1.68-2.67]). In five controlled studies, peptic-ulcer disease was significantly more common in NSAID takers (138/385 [35.8%]) than in controls (23/276 [8.3%]), irrespective of H pylori infection. Compared with H pylori negative individuals not taking NSAIDs, the risk of ulcer in H pylori infected NSAID takers was 61.1 (9.98-373). H pylori infection increased the risk of peptic-ulcer disease in NSAID takers 3.53-fold in addition to the risk associated with NSAID use (odds ratio 19.4). Similarly, in the presence of risk of peptic-ulcer disease associated with H pylori infection (18.1), use of NSAIDs increased the risk of peptic-ulcer disease 3.55-fold. H pylori infection and NSAID use increased the risk of ulcer bleeding 1.79-fold and 4.85-fold, respectively. However, the risk of ulcer bleeding increased to 6.13 when both factors were present.Interpretation: Both H pylori infection and NSAID use independently and significantly increase the risk of peptic ulcer and ulcer bleeding. There is synergism for the development of peptic ulcer and ulcer bleeding between H pylori infection and NSAID use. Peptic-ulcer disease is rare in H pylori negative non-NSAID takers. pubtype: Academic Journal doctype: meta analysis research systematic review Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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