The Korean Journal of Gastroenterology :eISSN 2233-6869 / pISSN 1598-9992

 

Table. 1.

Summary of the Evidence According to PICO; Does Eradication of Helicobacter pylori Prevent Peptic Ulcer and Its Complication in Patients with Long-term Nonsteroidal Anti-inflammatory Drug Therapy?

Reference Study design Participants Intervention and comparator Outcomes reported Primary outcome
Chan et al. (1997)11 RCT NSAID naive user who had H pylori infection but no pre-existing ulcers on endoscopy H. pylori eradication (1-week course of triple therapy) vs. no eradication ITT: 3/45 (7%) vs. 12/47 (26%) (p=0.01) Cumulative rate of gastric and duodenal ulcers
PP: 2/38 (5%) vs. 12/43 (28%) (p=0.04)
Chan et al. (2002)12 RCT NSAID naive user, had a positive urea breath test, had dyspepsia or an ulcer history H. pylori eradication (triple therapy) vs. Placebo ITT: 5/51 vs. 15/49 Endoscopically proven gastric or duodenal ulcers
The 6-month probability of ulcer12.1% vs. 34.4% (p=0.0085)
6-month probabilities of complicated ulcer: 4.2% vs. 27.1% (p=0.0026)
Labenz et al. (2002)13 RCT H pylori positive patients requiring NSAID therapy who had no past or current peptic ulcer H. pylori eradication vs. placebo vs. PPI 2/161 vs. 10/171 (p=0.037) The proportion of patients with endoscopically proved peptic ulcer
De Leest et al. (2007)14 RCT Patients on long-term NSAID treatment and who are H. pylori positive H. pylori eradication vs. placebo 6/155 vs. 8/160 (p=0.645) The presence of endoscopic gastric or duodenal ulcers after 3 months
Hawkey et al. (1998)15 RCT Patients requiring continuous NSAID treatment and who had H. pylori infection H. pylori eradication vs. PPI The estimated probability of being ulcer-free at 6 months: 0.56 (95% CI 0.47-0.65) vs. (0.44-0.62) (p=0.80) Recurrence of ulceration and dyspepsia after H pylori eradication
Lai et al. (2003)16 RCT Patients infected with H. pylori receiving long-term NSAID therapy H. pylori eradication vs. placebo ITT: 5/70 (7.1%) vs. 6 (8.6%) (p=1.00) Cumulative incidence of endoscopic ulcers
PP: 5 (7.5%) vs. 6 (9.2%) (p=0.76)

PICO, population, intervention, comparison, outcome; RCT, randomized controlled trial; NSAID, nonsteroidal anti-inflammatory drug; H. pylori, reat; PP, per-protocol; PPI, proton pump inhibitor; CI, confidence interval.

Korean J Gastroenterol 2020;76:227~231 https://doi.org/10.4166/kjg.2020.141
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