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Titolo:
Helicobacter pylori infection and the use of NSAIDs
Autore:
Bazzoli, F; De Luca, L; Graham, DY;
Indirizzi:
Vet Affairs Med Ctr, Dept Med, Houston, TX 77030 USA Vet Affairs Med Ctr Houston TX USA 77030 Dept Med, Houston, TX 77030 USA Baylor Coll Med, Houston, TX 77030 USA Baylor Coll Med Houston TX USA 77030 ylor Coll Med, Houston, TX 77030 USA Univ Bologna, Policlin S Orsola, Dept Internal Med & Gastroenterol, I-40126 Bologna, Italy Univ Bologna Bologna Italy I-40126 Gastroenterol, I-40126 Bologna, Italy
Titolo Testata:
BEST PRACTICE & RESEARCH IN CLINICAL GASTROENTEROLOGY
fascicolo: 5, volume: 15, anno: 2001,
pagine: 775 - 785
SICI:
1521-6918(200110)15:5<775:HPIATU>2.0.ZU;2-S
Fonte:
ISI
Lingua:
ENG
Soggetto:
NONSTEROIDAL ANTIINFLAMMATORY DRUGS; RANDOMIZED CONTROLLED TRIAL; ANTI-INFLAMMATORY DRUGS; GASTRIC-MUCOSAL INJURY; BLEEDING PEPTIC-ULCER; LOW-DOSE ASPIRIN; DOUBLE-BLIND; RISK-FACTORS; CYCLOOXYGENASE-2 INHIBITOR; GASTROINTESTINAL TOXICITY;
Keywords:
Helicobacter pylori; NSAIDs; peptic ulcer; gastric ulcer; duodenal ulcer; antisecretory therapy;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
63
Recensione:
Indirizzi per estratti:
Indirizzo: Graham, DY Vet Affairs Med Ctr, Dept Med, 111D,2002 Holcombe Blvd, Houston, TX 77030 USA Vet Affairs Med Ctr 111D,2002 Holcombe Blvd Houston TX USA 77030
Citazione:
F. Bazzoli et al., "Helicobacter pylori infection and the use of NSAIDs", BEST PR RES, 15(5), 2001, pp. 775-785

Abstract

Helicobacter pylori infection and the use of non-steroidal anti-inflammatory drugs (NSAIDs) can each result in gastroduodenal ulcers and ulcer complications. Recent studies have suggested that there is an interaction betweenthe two causes such that elimination of H. pylori before NSAID treatment decreases the occurrence of ulcers. This led to the conclusion of the Maastricht 2000 meeting that H. pylori eradication should be considered before embarking on long-term NSAID therapy. One of the main sources of confusion isrelated to the fact that prospective endoscopic studies testing various drugs for prevention of NSAID ulcers among chronic NSAID users are probably not directly applicable to problems of clinical ulcers and of ulcer complications. It has become clear that, to be interpretable clinically, such studies must provide separate analyses based on H. pylori status, history of ulcer, or an ulcer complication. Overall, the data strongly support the notionthat eradication therapy is beneficial for primary prophylaxis. In contrast, one would expect little benefit when NSAIDs caused the clinical ulcer (secondary prevention) and, at best, H. pylori eradication has a modest effect on the prevention of recurrent ulcer bleeding in NSAID users who have suffered ulcer complications. The data support the notion that H. pylori eradication therapy should be given to all H. pylori-infected patients with peptic ulcers irrespective of whether or not they have used NSAIDs. Proton pumpinhibitors are superior to placebo for the prevention of ulcer recurrence but are inferior to full-dose misoprostol for the prevention of ulcers among those with NSAID ulcers and no H. pylori infection. Selective COX-2 inhibitors appear to reduce markedly, but not eliminate, ulcer complications among chronic NSAID users.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 17/01/20 alle ore 21:07:40