Prevalence of Helicobacter pylori in acromegalic patients during treatment with octreotide.
BACKGROUND
Octreotide, a synthetic long-acting analogue of somatostatin, now has an established role in the treatment of acromegaly. In acromegalic patients treated with octreotide there is an increased incidence of gallstones and possibly gastritis.


OBJECTIVE
(1) To compare the seroprevalence of Helicobacter pylori (H. pylori) infection, in acromegalic patients treated with octreotide to that in patients given other treatment modalities. (2) To study retrospectively the temporal relation between H. pylori acquisition and octreotide treatment.


METHODS
Three groups of acromegalic patients were studied; 35 (20 M) had been treated with octreotide, 17 (10 M) with bromocriptine and 19 (12 M) had received no pharmacological intervention (untreated, surgically treated or treated with radiotherapy).


METHODS
The presence of H. pylori infection was assessed serologically (Bio-Rad GAP test for IgG), using stored serum, on the most recent sample from each patient and on serial samples from patients treated with octreotide.


RESULTS
The prevalence of H. pylori seropositivity was similar in each treatment group, 34, 35 and 37%, respectively. Mean age and duration of acromegaly were similar in the first two groups. Patients who had never received medical treatment were slightly younger. GH levels were similar in all three groups. Patients on octreotide who were seropositive for H. pylori did not differ from those with negative serology with respect to age, duration of acromegaly, duration of octreotide treatment or serum GH level. Serial samples in octreotide treated patients showed a change in status in only one patient; 18 patients continued with negative serology during a mean period of 30 (range 4-62) months. In each of the 6 patients with persistently positive serology during octreotide treatment, stored samples predating octreotide therapy were shown to have already been positive.


CONCLUSIONS
The seroprevalence of H. pylori infection in acromegalic patients does not appear to be increased in a manner dependent on the type or duration of medical treatment. In particular, octreotide therapy, while causing the development of histological gastritis in some patients, does not appear to induce the development of H. pylori infection.
Jones
S L
SL
Department of Endocrinology, St Bartholomew's Hospital, West Smithfield, London, UK.
Patchett
S
S
Anderson
J V
JV
Farthing
M J
MJ
Besser
G M
GM
Wass
J A
JA
D000172:Acromegaly / Q000188:drug therapy*; D000328:Adult; D000368:Aged; D004334:Drug Administration Schedule; D005260:Female; D005756:Gastritis / Q000139:chemically induced / Q000382:microbiology; D016481:Helicobacter Infections / Q000139:chemically induced*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006728:Hormones / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000009:adverse effects* / Q000627:therapeutic use; D012189:Retrospective Studies
D006728:Hormones; D015282:Octreotide