Helicobacter pylori Eradication in Patients on Long-term Treatment With NSAIDs Reduces the Severity of Gastritis A Randomized Controlled Trial

H.T.J.I. de Leest, K.S.S. Steen, E. Bloemena, W.F. Lems, E. Kuipers, M.C. van der Laar, J.J.E. Bijlsma, M.M.J. Janssen, H.H. Houben, P.J. Kostense, M. Boers, B.A.C. Dijkmans

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Abstract

Background: Maintenance use of nonsteroidal anti-inflammatory drugs (NSAIDs) is often complicated by gastropathy. In non-NSAID users, eradication of Helicobacter pylori is associated with decreased mucosal inflammation, and may halt the progression to atrophy and intestinal metaplasia, but the continuous use of NSAIDs may interfere with these processes. Goal: To investigate the effect of H. pylori eradication on gastric mucosal histology during long-term NSAID use, with and without gastroprotective therapy. Study: Patients were eligible for inclusion if they were on long-term NSAIDs and were H. pylori-positive on serologic testing. Patients were randomly assigned to either eradication or placebo. Gastritis was assessed according to the updated Sydney classification for activity, chronic inflammation, gastric glandular atrophy, intestinal metaplasia, and H. pylori density. Results: Biopsy specimens were available for histology of 305 patients. Or these, 48% were on chronic gastroprotective medication. Significant less active gastritis, inflammation. and H. pylori density was found in the eradication group compared with the placebo group in both Corpus and antrum (P <0.001). In the corpus, less atrophy was found in the eradication group Compared with the placebo group. Conclusions: H. pylori eradication in patients on long-term NSAID therapy leads to healing of gastritis despite ongoing NSAID therapy
Original languageUndefined/Unknown
Pages (from-to)140-146
Number of pages7
JournalJournal of Clinical Gastroenterology
Volume43
Issue number2
DOIs
Publication statusPublished - 2009

Cite this

de Leest, H.T.J.I. ; Steen, K.S.S. ; Bloemena, E. ; Lems, W.F. ; Kuipers, E. ; van der Laar, M.C. ; Bijlsma, J.J.E. ; Janssen, M.M.J. ; Houben, H.H. ; Kostense, P.J. ; Boers, M. ; Dijkmans, B.A.C. / Helicobacter pylori Eradication in Patients on Long-term Treatment With NSAIDs Reduces the Severity of Gastritis A Randomized Controlled Trial. In: Journal of Clinical Gastroenterology. 2009 ; Vol. 43, No. 2. pp. 140-146.
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abstract = "Background: Maintenance use of nonsteroidal anti-inflammatory drugs (NSAIDs) is often complicated by gastropathy. In non-NSAID users, eradication of Helicobacter pylori is associated with decreased mucosal inflammation, and may halt the progression to atrophy and intestinal metaplasia, but the continuous use of NSAIDs may interfere with these processes. Goal: To investigate the effect of H. pylori eradication on gastric mucosal histology during long-term NSAID use, with and without gastroprotective therapy. Study: Patients were eligible for inclusion if they were on long-term NSAIDs and were H. pylori-positive on serologic testing. Patients were randomly assigned to either eradication or placebo. Gastritis was assessed according to the updated Sydney classification for activity, chronic inflammation, gastric glandular atrophy, intestinal metaplasia, and H. pylori density. Results: Biopsy specimens were available for histology of 305 patients. Or these, 48{\%} were on chronic gastroprotective medication. Significant less active gastritis, inflammation. and H. pylori density was found in the eradication group compared with the placebo group in both Corpus and antrum (P <0.001). In the corpus, less atrophy was found in the eradication group Compared with the placebo group. Conclusions: H. pylori eradication in patients on long-term NSAID therapy leads to healing of gastritis despite ongoing NSAID therapy",
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Helicobacter pylori Eradication in Patients on Long-term Treatment With NSAIDs Reduces the Severity of Gastritis A Randomized Controlled Trial. / de Leest, H.T.J.I.; Steen, K.S.S.; Bloemena, E.; Lems, W.F.; Kuipers, E.; van der Laar, M.C.; Bijlsma, J.J.E.; Janssen, M.M.J.; Houben, H.H.; Kostense, P.J.; Boers, M.; Dijkmans, B.A.C.

In: Journal of Clinical Gastroenterology, Vol. 43, No. 2, 2009, p. 140-146.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Helicobacter pylori Eradication in Patients on Long-term Treatment With NSAIDs Reduces the Severity of Gastritis A Randomized Controlled Trial

AU - de Leest, H.T.J.I.

AU - Steen, K.S.S.

AU - Bloemena, E.

AU - Lems, W.F.

AU - Kuipers, E.

AU - van der Laar, M.C.

AU - Bijlsma, J.J.E.

AU - Janssen, M.M.J.

AU - Houben, H.H.

AU - Kostense, P.J.

AU - Boers, M.

AU - Dijkmans, B.A.C.

PY - 2009

Y1 - 2009

N2 - Background: Maintenance use of nonsteroidal anti-inflammatory drugs (NSAIDs) is often complicated by gastropathy. In non-NSAID users, eradication of Helicobacter pylori is associated with decreased mucosal inflammation, and may halt the progression to atrophy and intestinal metaplasia, but the continuous use of NSAIDs may interfere with these processes. Goal: To investigate the effect of H. pylori eradication on gastric mucosal histology during long-term NSAID use, with and without gastroprotective therapy. Study: Patients were eligible for inclusion if they were on long-term NSAIDs and were H. pylori-positive on serologic testing. Patients were randomly assigned to either eradication or placebo. Gastritis was assessed according to the updated Sydney classification for activity, chronic inflammation, gastric glandular atrophy, intestinal metaplasia, and H. pylori density. Results: Biopsy specimens were available for histology of 305 patients. Or these, 48% were on chronic gastroprotective medication. Significant less active gastritis, inflammation. and H. pylori density was found in the eradication group compared with the placebo group in both Corpus and antrum (P <0.001). In the corpus, less atrophy was found in the eradication group Compared with the placebo group. Conclusions: H. pylori eradication in patients on long-term NSAID therapy leads to healing of gastritis despite ongoing NSAID therapy

AB - Background: Maintenance use of nonsteroidal anti-inflammatory drugs (NSAIDs) is often complicated by gastropathy. In non-NSAID users, eradication of Helicobacter pylori is associated with decreased mucosal inflammation, and may halt the progression to atrophy and intestinal metaplasia, but the continuous use of NSAIDs may interfere with these processes. Goal: To investigate the effect of H. pylori eradication on gastric mucosal histology during long-term NSAID use, with and without gastroprotective therapy. Study: Patients were eligible for inclusion if they were on long-term NSAIDs and were H. pylori-positive on serologic testing. Patients were randomly assigned to either eradication or placebo. Gastritis was assessed according to the updated Sydney classification for activity, chronic inflammation, gastric glandular atrophy, intestinal metaplasia, and H. pylori density. Results: Biopsy specimens were available for histology of 305 patients. Or these, 48% were on chronic gastroprotective medication. Significant less active gastritis, inflammation. and H. pylori density was found in the eradication group compared with the placebo group in both Corpus and antrum (P <0.001). In the corpus, less atrophy was found in the eradication group Compared with the placebo group. Conclusions: H. pylori eradication in patients on long-term NSAID therapy leads to healing of gastritis despite ongoing NSAID therapy

U2 - 10.1097/MCG.0b013e3181595b40

DO - 10.1097/MCG.0b013e3181595b40

M3 - Article

VL - 43

SP - 140

EP - 146

JO - Journal of Clinical Gastroenterology

JF - Journal of Clinical Gastroenterology

SN - 0192-0790

IS - 2

ER -