Outcome of immunosuppressive therapy with Helicobacter pylori eradication therapy in patients with chronic idiopathic thrombocytopenic purpura.
We initiated this study to investigate whether combining Helicobacter pylori eradication with immunosuppressive therapy provides an additional benefit to patients with idiopathic thrombocytopenic purpura (ITP) that has relapsed or has not responded to steroid and/or danazol therapy in patients who have H. pylori infection. Thirty- four patients with chronic ITP that had relapsed or failed to steroid and/or danazol therapy were assessed for H. pylori infection. Of the 21 confirmed cases, 12 patients were given H. pylori eradication therapy alone (EA), while 9 patients received eradication therapy combined with immunosuppressive therapy (EI). The response rate was not significantly different between patients in the EA and those in the EI group (41.7% in the EA group vs. 66.7% in the EI group, p=0.345). The median platelet count at 6 months after therapy was higher in the EI group patients (75 x 10(9)/L in the EI group patients vs. 18 x 10(9)/L in the EA group patients, p=0.028). The median response duration was also longer in the EI group patients (9 months in the EI group patients vs. 3 months in the EA group patients, p=0.049). These results show that a significant benefit is gained by the use of H. pylori eradication combined with immunosuppressive therapy over the use of eradication therapy alone for patients with chronic ITP.
Song
Moo-Kon
MK
Department of Internal Medicine, School of Medicine, Pusan National University, Busan, Korea.
Chung
Joo-Seop
JS
Shin
Ho-Jin
HJ
Choi
Young-Jin
YJ
Cho
Goon-Jae
GJ
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002908:Chronic Disease; D003613:Danazol / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D004965:Estrogen Antagonists / Q000008:administration & dosage; D005260:Female; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications / Q000188:drug therapy*; D013256:Steroids / Q000008:administration & dosage; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D004965:Estrogen Antagonists; D007166:Immunosuppressive Agents; D013256:Steroids; D003613:Danazol