Does helicobacter pylori exacerbate gastric mucosal injury in users of nonsteroidal anti-inflammatory drugs? a multicenter, retrospective, case-control study

Yoshiyasu Kono, Hiroyuki Okada, Ryuta Takenaka, Ko Miura, Hiromitsu Kanzaki, Keisuke Hori, Masahide Kita, Takao Tsuzuki, Seiji Kawano, Yoshiro Kawahara, Kazuhide Yamamoto

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)69-75
Number of pages7
JournalGut and Liver
Volume10
Issue number1
DOIs
Publication statusPublished - Jan 1 2016

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Helicobacter pylori
Case-Control Studies
Stomach
Anti-Inflammatory Agents
Odds Ratio
Confidence Intervals
Wounds and Injuries
Helicobacter Infections
Pharmaceutical Preparations
Proton Pump Inhibitors
Drug Users
Digestive System Endoscopy
Aspirin
Multivariate Analysis
Logistic Models
Regression Analysis

Keywords

  • Anti-inflammatory agents, non-steroidal
  • Gastric mucosal injury
  • Helicobacter pylori
  • Proton pump inhibitors

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Does helicobacter pylori exacerbate gastric mucosal injury in users of nonsteroidal anti-inflammatory drugs? a multicenter, retrospective, case-control study. / Kono, Yoshiyasu; Okada, Hiroyuki; Takenaka, Ryuta; Miura, Ko; Kanzaki, Hiromitsu; Hori, Keisuke; Kita, Masahide; Tsuzuki, Takao; Kawano, Seiji; Kawahara, Yoshiro; Yamamoto, Kazuhide.

In: Gut and Liver, Vol. 10, No. 1, 01.01.2016, p. 69-75.

Research output: Contribution to journalArticle

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abstract = "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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AU - Takenaka, Ryuta

AU - Miura, Ko

AU - Kanzaki, Hiromitsu

AU - Hori, Keisuke

AU - Kita, Masahide

AU - Tsuzuki, Takao

AU - Kawano, Seiji

AU - Kawahara, Yoshiro

AU - Yamamoto, Kazuhide

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KW - Proton pump inhibitors

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