Helicobacter pylori and NSAID-induced gastric ulcer in a Japanese population.
A recent meta-analysis by Huang et al. clarified that Helicobacter pylori infection and nonsteroidal antiinflammatory drugs (NSAIDs) are important factors for peptic ulcer. The results showed that the risk for ulcer in NSAID(+)/H. pylori(+) patients was 61.1 fold higher when compared with NSAID(-)/H. pylori(-) patients. Some gastric ulcers detected in patients on NSAID therapy may actually be caused by H. pylori, but it is difficult to differentiate NSAID-induced gastric ulcer from H. pylori-induced gastric ulcer. Several studies have investigated the effects of H. pylori eradication on ulcer healing. One study reported that H. pylori eradication actually lowered the healing rate of gastric ulcers. Because there have been no studies finding that H. pylori eradication facilitates healing, H. pylori eradication is not recommended for NSAID users. Concerning the efficacy of H. pylori eradication in the prevention of NSAID-induced gastric ulcer, a meta-analysis concluded that among all patients on NSAID therapy, H. pylori eradication lowered the prevalence of ulcer, which was particularly marked in NSAID-naïve patients. When compared with those of proton pump inhibitors (PPIs), the preventative effects of H. pylori eradication were inferior. In Japan, national health insurance does not cover procedures that prevent or lower the risk for NSAID-induced ulcer. When administering NSAID to patients with risk factors, it is desirable to administer antiulcer agents.
Murakami
Kazunari
K
Department of Gastroenterology, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Oita, 879-5593, Japan.
Okimoto
Tadayoshi
T
Kodama
Masaaki
M
Tanahashi
Jin
J
Yasaka
Shigeaki
S
Inoue
Kunimitsu
K
Uchida
Masahiro
M
Anan
Juro
J
Mizukami
Kazuhiro
K
Abe
Takashi
T
Watada
Masahide
M
Fujioka
Toshio
T
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D044466:Asian People; D002986:Clinical Trials as Topic; D016481:Helicobacter Infections / Q000150:complications* / Q000188:drug therapy; D016480:Helicobacter pylori / Q000187:drug effects / Q000302:isolation & purification; D006801:Humans; D019458:Insurance Coverage / Q000191:economics; D007564:Japan / Q000453:epidemiology; D009313:National Health Programs / Q000191:economics; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D013276:Stomach Ulcer / Q000139:chemically induced* / Q000188:drug therapy / Q000382:microbiology
D000894:Anti-Inflammatory Agents, Non-Steroidal; D054328:Proton Pump Inhibitors