Treatment of Helicobacter pylori in patients with duodenal ulcer hemorrhage- a long-term randomized, controlled study
- 1 September 2000
- journal article
- clinical trial
- Published by Ovid Technologies (Wolters Kluwer Health) in The American Journal of Gastroenterology
- Vol. 95 (9), 2225-2232
- https://doi.org/10.1111/j.1572-0241.2000.02249.x
Abstract
Eradication of Helicobacter pylori (H. pylori) in patients with uncomplicated duodenal ulcers prevents long-term recurrence of ulcers. We aimed to study whether treatment of H. pylori prevents the long-term recurrence of duodenal ulcer hemorrhage. Patients with duodenal ulcer bleeding and confirmed H. pylori infection were recruited. A total of 120 patients were randomly assigned to triple therapy (DeNoltab 120 mg, amoxycillin 500 mg, and metronidazole 300 mg four times daily) or DeNoltab 120 mg four times daily alone. No maintenance therapy was given during the follow-up period. The endpoints were the cumulative rates of symptomatic and bleeding duodenal ulcer recurrences. Of the patients receiving the triple regimen, 85.1% had H. pylori eradicated as compared to 2.0% of patients receiving DeNoltab (p < 0.05). More patients in the DeNoltab group than those in the Triple group had recurrence of ulcer bleeding, but this did not reach statistical significance (12/60 vs 6/60, p = 0.20). Logistic regression analysis on clinical, personal, and endoscopic characteristics identified persistent H. pylori infection as the only independent predictor of recurrence of duodenal ulcer bleeding. Treatment of H. pylori alone with the present bismuth-based triple therapy in patients with duodenal ulcer hemorrhage did not result in significant reduction in further bleeding episodes, although a trend was seen for the group that was given triple therapy. On the other hand, posttreatment H. pylori status was found to be an independent predictor of bleeding recurrence.Keywords
This publication has 23 references indexed in Scilit:
- Comparison of invasive and noninvasive tests for detecting Helicobacter pylori infection in bleeding peptic ulcersGastrointestinal Endoscopy, 1999
- A longitudinal analysis of hepatitis C virus replication following liver transplantationGastroenterology, 1996
- Helicobacter pylori in Peptic Ulcer DiseaseJAMA, 1994
- Role of Helicobacter pylori Eradication in the Prevention of Peptic Ulcer Bleeding RelapseDigestion, 1994
- Evidence for the essential role of Helicobacter pylori in gastric ulcer disease.Gut, 1994
- Effect of Ranitidine and Amoxicillin plus Metronidazole on the Eradication of Helicobacter pylori and the Recurrence of Duodenal UlcerNew England Journal of Medicine, 1993
- Treatment of Helicobacter pylori Reduces the Rate of Rebleeding in Peptic Ulcer DiseaseScandinavian Journal of Gastroenterology, 1993
- Effect of Treatment of Helicobacter pylori Infection on the Long-term Recurrence of Gastric or Duodenal UlcerAnnals of Internal Medicine, 1992
- Cure of duodenal ulcer associated with eradication of Helicobacter pyloriThe Lancet, 1990
- PROSPECTIVE DOUBLE-BLIND TRIAL OF DUODENAL ULCER RELAPSE AFTER ERADICATION OF CAMPYLOBACTER PYLORIThe Lancet, 1988