1.Seven days triple therapy for eradication of Helicobacter pylori does not alter the disease activity of patients with inflammatory bowel disease.
Shinichiro SHINZAKI ; Toshimitsu FUJII ; Shigeki BAMBA ; Maiko OGAWA ; Taku KOBAYASHI ; Masahide OSHITA ; Hiroki TANAKA ; Keiji OZEKI ; Sakuma TAKAHASHI ; Hiroki KITAMOTO ; Kazuhito KANI ; Sohachi NANJO ; Takeshi SUGAYA ; Yuko SAKAKIBARA ; Toshihiro INOKUCHI ; Kazuki KAKIMOTO ; Akihiro YAMADA ; Hisae YASUHARA ; Yoko YOKOYAMA ; Takuya YOSHINO ; Akira MATSUI ; Misaki NAKAMURA ; Taku TOMIZAWA ; Ryosuke SAKEMI ; Noriko KAMATA ; Toshifumi HIBI
Intestinal Research 2018;16(4):609-618
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.
Clarithromycin
;
Cohort Studies
;
Colitis, Ulcerative
;
Helicobacter pylori*
;
Helicobacter*
;
Humans
;
Inflammatory Bowel Diseases*
;
Metronidazole
;
Multivariate Analysis
;
Retrospective Studies
Result Analysis
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