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 25 May 2018

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News

Therapy for the prevention of recurrent bleeding from peptic ulcers

H. pylori eradication is more effective than antisecretory non-eradication therapy for the prevention on peptic ulcer rebleeding, find investigators in the latest issue of Alimentary Pharmacology and Therapeutics.

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In this study, investigators from Spain compared Helicobacter pylori eradication therapy and antisecretory non-eradication therapy for the prevention of recurrent peptic ulcer bleeding.

The team searched the Cochrane Controlled Trials Register, MEDLINE, EMBASE, CINAHL and several congresses for controlled clinical trials comparing the 2 therapies.

They excluded studies where all patients were taking non-steroidal anti-inflammatory drugs.
In patients with successful H. pylori eradication, the rebleeding rate was 1%.
Alimentary Pharmacology and Therapeutics

The team performed 2 meta-analyses. In the first, they found that mean percentage of rebleeding in the eradication group was 5%, compared with 24% in the non-eradication group without long-term antisecretory therapy.

In the second, the rebleeding rate in the eradication group was 2%, compared with 6% in the non-eradication group with maintenance antisecretory therapy. Furthermore, when team only included patients with successful H. pylori eradication were included, the rebleeding rate was 1%.

Dr Gisbert and colleagues concluded, "The treatment of H. pylori infection is more effective than antisecretory non-eradication therapy…in the prevention of recurrent bleeding from peptic ulcer".

"Consequently, all patients with peptic ulcer bleeding should be tested for H. pylori, and eradication therapy should be prescribed to infected patients."

Aliment Pharmacol Ther 2004; 19(6): 617-29
18 March 2004

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