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 20 May 2018

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News

Population-based trials of H. pylori eradication are feasible

Population-based trials of H. pylori eradication are feasible, but necessitate screening large numbers of people, to identify those who are infected and who may benefit from eradication, claims a team from the United Kingdom.

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The investigators studied eradication of Helicobacter pylori in the general population, and reported their findings in the latest issue of Controlled Clinical Trials.

Data came from the Bristol Helicobacter Project, an ongoing, pragmatic, double-blind placebo-controlled trial of the effect of H. pylori eradication on symptoms of dyspepsia, health utilization and costs, and quality of life in the adult population.

Commencing in 1996, 27,536 individuals, aged 20-59 years, were included in the study.

All were registered with 7 primary care centers in Bristol and the surrounding areas in southwest England, and were invited to undergo a 13C urea breath test.

There was no selection on the basis of symptoms.

Some 23.5% had dyspepsia on entry to the study.

Participation varied inversely with:
- Social deprivation
- Infection prevalence
Controlled Clinical Trials

A total of 10,537 people were tested (38.3% of those invited) for H. pylori. Of these, 1636 tested positive (15.5%).

The authors randomized 95.2% of those who tested positive to H. pylori eradication therapy or placebo.

The rate of participation in the screening phase increased with age (odds ratio [OR]: 1.42 per decade) and female gender (OR: 1.35)

However, it decreased with lower socioeconomic status (OR: 0.70 comparing lowest with highest category).

Furthermore, the researchers found that H. pylori prevalence increased with age (OR: 1.69 per decade) and lower socioeconomic status (OR: 1.33). However, it was lower in women (OR: 0.87).

Dr J. Athene Lane, of the University of Bristol, Bristol, England, said on behalf of the group, "Population-based trials of H. pylori eradication are feasible but necessitate screening large numbers of people to identify those who are infected and who may benefit from eradication."

"In the Bristol Helicobacter Project, the rate of participation varied inversely with both social deprivation and the prevalence of the infection," it was concluded.

Control Clin Trials 2002; 23(3): 321-32
12 June 2002

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