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KMID : 0988920180160040609
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Intestinal Research
2018 Volume.16 No. 4 p.609 ~ p.618
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Seven days triple therapy for eradication of Helicobacter pylori does not alter the disease activity of patients with inflammatory bowel disease
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Shinzaki Shinichiro
Fujii Toshimitsu
Bamba Shigeki
Ogawa Maiko
Kobayashi Taku
Oshita Masahide
Tanaka Hiroki
Ozeki Keiji
Takahashi Sakuma
Kitamoto Hiroki
Kani Kazuhito
Nanjo Sohachi
Sugaya Takeshi
Sakakibara Yuko
Inokuchi Toshihiro
Kakimoto Kazuki
Yamada Akihiro
Yasuhara Hisae
Yokoyama Yoko
Yoshino Takuya
Matsui Akira
Nakamura Misaki
Tomizawa Taku
Sakemi Ryosuke
Kamata Noriko
Hibi Toshifumi
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Abstract
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Background/Aims: The influences of Helicobacter pylori eradication therapy on the disease course of inflammatory bowel disease (IBD) are still unclear. We therefore conducted a multicenter, retrospective cohort study to evaluate the safety of H. pylori eradication therapy for IBD patients.
Methods: IBD patients with H. pylori eradication from 2005 to 2015 (eradication group) and control patients (non-eradication group; 2 paired IBD patients without H. pylori eradication matched with each eradicated patient) were included. IBD exacerbation (increased/additional IBD drug or IBD-associated hospitalization/surgery) and disease improvement based on the physicians’ global assessment were investigated at baseline, and at 2 and 6 months after eradication or observation.
Results: A total of 429 IBD (378 ulcerative colitis, 51 Crohn’s disease) patients, comprising 144 patients in the eradication group and 285 patients in the non-eradication group, were enrolled at 25 institutions. IBD exacerbation was comparable between groups (eradication group: 8.3% at 2 months [odds ratio, 1.76; 95% confidence interval, 0.78?3.92; P=0.170], 11.8% at 6 months [odds ratio, 1.60; 95% confidence interval, 0.81?3.11; P=0.172]). Based on the physicians’ global assessment at 2 months, none of the patients in the eradication group improved, whereas 3.2% of the patients in the non-eradication group improved (P=0.019). Multivariate analysis revealed that active disease at baseline, but not H. pylori eradication, was an independent factor for IBD exacerbation during 2 months’ observation period. The overall eradication rate was 84.0%?comparable to previous reports in non-IBD patients.
Conclusions: H. pylori eradication therapy does not alter the short-term disease activity of IBD.
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KEYWORD
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Helicobacter pylori eradication, Proton pump inhibitor, Clarithromycin, Metronidazole
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