Eradication of Helicobacter pylori did not accelerate the healing of gastric and duodenal ulcers / erosions in patients on long-term continuous nonsteroidal anti-inflammatory drugs

Abstract

INTRODUCTION: It is controversial whether Helicobacter pylori (H. pylori) acts synergistically with non-steroidal anti-inflammatory drugs (NSAIDs) to cause peptic ulcers. AIM: To study whether patients receiving NSAIDs with gastric or duodenal ulcers/erosions benefit from eradication of H. pylori infection. METHOD: 168 patients on long-term continuous NSAIDs from the Rheumatology Clinic were endoscoped during a period of 2 yrs. Group (I): 22 patients with ulcers (diameter > 3mm) and H. pylori were given ranitidine 150mg bd with or without H. pylori eradication therapy (metronidazole 300mg, amoxycillin 500mg and clarithromycin 250mg qid for 2 weeks - MAC). Ulcers healing rates were examined by 4 weekly endoscopies. Group (II): 26 patients with H. pylori and gastric or duodenal erosions were randomized to receive either (1) 2 weeks MAC qid or (2) 2 weeks placebo qid. Endoscopy was performed at the end of 12 wks with complete healing defined as no erosions, partial healing as reduced number of erosions and unhealing as same number of erosions detected. NSAIDs were continued in all patients. RESULTS: No patients suffered from clinical gastrointestinal bleeding at the end of study …