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 YoshinoAkira Matsui, Misaki Nakamura, Taku Tomizawa, Ryosuke Sakemi, Noriko Kamata, Toshifumi Hibi

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)609-618
Number of pages10
JournalIntestinal Research
Volume16
Issue number4
DOIs
Publication statusPublished - Oct 1 2018

Keywords

  • Clarithromycin
  • Helicobacter pylori eradication
  • Metronidazole
  • Proton pump inhibitor

ASJC Scopus subject areas

  • Gastroenterology

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    Shinzaki, S., Fujii, T., Bamba, S., Ogawa, M., Kobayashi, T., Oshita, M., Tanaka, H., Ozeki, K., Takahashi, S., Kitamoto, H., Kani, K., Nanjo, S., Sugaya, T., Sakakibara, Y., Inokuchi, T., Kakimoto, K., Yamada, A., Yasuhara, H., Yokoyama, Y., ... Hibi, T. (2018). Seven days triple therapy for eradication of Helicobacter pylori does not alter the disease activity of patients with inflammatory bowel disease. Intestinal Research, 16(4), 609-618. https://doi.org/10.5217/ir.2018.00044