Helicobacter pylori seroprevalence in patients with rheumatoid arthritis: effect of nonsteroidal anti-inflammatory drugs and gold compounds.
OBJECTIVE
To investigate the relationship between Helicobacter pylori infection and nonsteroidal anti-inflammatory drug (NSAID) intolerance and the effect of gold use on the seroprevalence of H. pylori.


METHODS
We examined the frequency of discontinuation of NSAIDs in 132 unselected patients with rheumatoid arthritis attending an outpatient subspecialty clinic, and the effect of gold compound use on the seroprevalence (by IgG enzyme-linked immunosorbent assay) of H. pylori infection in this population. Logistic and multivariate regression analysis was performed adjusting for age, gender, ethnic origin, history of ulcer, and duration of rheumatoid arthritis.


RESULTS
Fifty-four patients had a positive serology for H. pylori (41%). Twenty-seven of the seropositive patients (50%), versus 45 of the seronegative patients (57.7%), had to discontinue NSAIDs (aspirin and/or nonaspirin) at least once since their diagnosis of rheumatoid arthritis because of gastrointestinal side effects (odds ratio [OR], 0.93; 95% confidence interval [CI], 0.63 to 1.38). Forty-one of the seropositive patients (76%) had received gold compounds as compared with 62 of the seronegative patients (79.5%) (OR: 0.96; 95% CI: 0.61 to 1.50).


CONCLUSIONS
We did not find any relationship between H. pylori seropositivity and NSAID intolerance in patients with rheumatoid arthritis. In addition, our results do not demonstrate a reduction in H. pylori seroprevalence in rheumatoid arthritis patients treated with gold compounds.
Division of Gastroenterology, Henry Ford Hospital, Detroit, Michigan.
G P
GP
Gubbins
T T
TT
Schubert
F
F
Attanasio
M
M
Lubetsky
G I
GI
Perez-Perez
M J
MJ
Blaser
D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D004415:Dyspepsia / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D016481:Helicobacter Infections / Q000150:complications* / Q000453:epidemiology / Q000517:prevention & control; D016480:Helicobacter pylori / Q000187:drug effects / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D050607:Organogold Compounds; D015995:Prevalence; D012044:Regression Analysis; D016036:Seroepidemiologic Studies
D000894:Anti-Inflammatory Agents, Non-Steroidal; D018501:Antirheumatic Agents; D050607:Organogold Compounds