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KMID : 1188320160100010069
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Gut and Liver
2016 Volume.10 No. 1 p.69 ~ p.75
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Does Exacerbate Gastric Mucosal Injury in Users of Nonsteroidal Anti-Inflammatory Drugs? A Multicenter, Retrospective, Case-Control Study
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Yoshiyasu Kono
Hiroyuki Okada
Ryuta Takenaka
Ko Miura
Hiromitsu Kanzaki
Keisuke Hori
Masahide Kita
Takao Tsuzuki
Yoshiro Kawahara
Kazuhide Yamamoto
Seiji Kawano
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Abstract
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Background/Aims:The interaction between nonsteroidal anti-inflammatory drugs (NSAIDs) and Helicobacter pylori remains controversial. We retrospectively investigated whether H. pylori infection exacerbates severe gastric mucosal injury among chronic NSAID users.
Methods:From January 2010 to December 2013, a total of 245 long-term NSAID (including low-dose aspirin) users who had undergone an esophagogastroduodenoscopy and had been evaluated for H. pylori infection were enrolled at Okayama University Hospital and Tsuyama Chuo Hospital. The degree of gastric mucosal injury was assessed according to the modified Lanza score (MLS). Severe gastric mucosal injury was defined as an MLS ≥4. Univariate and multivariate logistic regression analyses were performed.
Results:In the univariate analysis, age ≥75 years (odds ratio [OR], 2.4; 95% confidence interval [CI], 1.3 to 4.2), H. pylori-positivity (OR, 2.0; 95% CI, 1.2 to 3.5), and the concomitant use of proton pump inhibitors (PPIs) (OR, 0.48; 95% CI, 0.26 to 0.86) were significantly associated with severe gastric mucosal injury. The multivariate analysis was adjusted by age and sex and demonstrated that H. pylori-positivity (OR, 1.8; 95% CI, 1.0 to 3.3) and the concomitant use of PPIs (OR, 0.53; 95% CI, 0.28 to 0.99) significantly contributed to severe gastric mucosal injury.
Conclusions:H. pylori infection exacerbates severe gastric mucosal injury among chronic NSAID users.
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KEYWORD
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Anti-inflammatory agents, non-steroidal, Helico-bacter pylori, Gastric mucosal injury, Proton pump inhibitors
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