A team from Oxford and Taplow, England, investigated the role of H. pylori eradication in the treatment of ulcer-like dyspepsia in primary care.
Their findings were reported to the British Society of Gastroenterology Annual Conference, held this week in Glasgow, Scotland.
543 patients from 64 primary care centers in the UK and Norway were enrolled into the study. Individuals with confirmed ulcer were excluded from the investigation.
364 patients were assessed as H. pylori-positive by near patient antibody blood test.
Of these, 181 patients were randomized to receive eradication therapy (lansoprazole 30 mg, clarithromycin 250 mg and amoxycillin 1g, all twice a day) for 1 week, followed by lansoprazole 30 mg once a day for 3 or 7 weeks, according to symptoms.
|Ulcer-like dyspepsia relapse rate:|
Eradication therapy group 37%
Lansoprazole only, H. pylori-positive 51%
Lansoprazole only, H. pylori-negative 59%
British Society of Gastroenterology Annual Meeting|
183 subjects received placebo antibiotics and lansoprazole 30 mg once a day for 4 or 8 weeks.
179 H. pylori-negative patients received open treatment with lansoprazole 30 mg once a day for 4 or 8 weeks.
Epigastric pain, and other gastrointestinal symptoms, consultations, prescriptions, and investigations were recorded during the treatment period and over a 12-month follow-up phase.
The researchers found the relapse rate of ulcer-like dyspepsia during the follow-up period, to be 37% in subjects who underwent eradication therapy. In subjects receiving just lansoprazole, relapse rates were 51% and 59% for H. pylori-positive and negative individuals, respectively.
The average number of GI consultations and prescriptions was lower in the eradication group compared with the H. pylori-positive, non-eradicated group.
Richard Stevens, of the East Oxford Health Centre, concluded on behalf of the group, "H. pylori eradication resulted in a significant reduction in symptomatic relapse in patients presenting with ulcer-like dyspepsia in primary care.
"This was associated with a reduction in the number of GI consultations and prescriptions over the subsequent 12 months."