H. pylori eradication therapy for patients receiving nonsteroid antiinflammatory drugs
Abstract
The aim of review. To demonstrate value of H. pylori eradication therapy in patients for prophylaxis and treatment of nonsteroid antiinflammatory drugs (NSAID)- induced gastropathies.
Key points. NSAID and H. pylori act as independent risk factors of ulcer development. Eradication therapy is the major way of prevention of gastroduodenal ulcer and its complications, especially if prophylaxis is carried out prior to onset of NSAID treatment. At long-term application of NSAID the preventive effect of H. pylori eradication is less pronounced. Low doses or special aspirin preparations can not only cause erosions and ulcers, but also result in development of gastro-intestinal bleedings. Well-timed eradication therapy in patients receiving aspirin can decrease risk of ulcer bleeding even without maintenance treatment by proton pump inhibitors (PPI). Diagnostics H. pylori with prescription of antihelicobacter therapy at positive result should be provided in all patients receiving aspirin, with peptic ulcer in past history. Pantoprazole should be preferred at complex treatment of these patients to decrease adverse effects due to drug interaction.
Conclusion. Successful and well-timed combination of eradication treatment and standalone PPI therapy is the important prerequisite in avoidance of dangerous gastro-intestinal complications at intake of NSAID and aspirin.
About the Authors
V. T. Ivashkin
ПМГМУ им. И.М. Сеченова Минздравсоцразвития РФ
Russian Federation
Russian Federation
T. L. Lapina
ПМГМУ им. И.М. Сеченова Минздравсоцразвития РФ
Russian Federation
Russian Federation
References
1. Гусева Л.В., Бурдина Е.Г., Савенков А.А., Черезова И.Н. Причины желудочно-кишечных кровотечений в поликлинической практике // Рос. журн. гастроэнтерол. гепатол. колопроктол. – 2012. – Т. 21, № 5 (прил. 40). – С. 23.
2. Касимцева Е.В., Бурков С.Г., Агафонова Л.Ю. Состояние верхних отделов пищеварительного тракта у пациентов старческого возраста // Там же. – С. 28.
3. Лапина Т.Л. Возможности лекарственного воздействия на цитопротективные свойства гастродуоденальной слизистой оболочки // Рос. журн. гастроэнтерол. гепатол. колопроктол. – 2006. – Т. 16, № 5. – С. 75–80.
4. Лапина Т.Л., Коньков М.Ю., Ивашкин В.Т. и др. Отдаленные результаты эрадикационной терапии при атрофическом гастрите // Врач. – 2009. – № 3. – С. 47–50.
5. Ярустовский М.Б. и др. Эффективность применения антисекреторных препаратов в лечении острых эрозивно-язвенных повреждений у больных с приобретенными заболеваниями сердца // Рос. журн. гастроэнтерол. гепатол. колопроктол. – 2004. – Т. 14, № 6. – С. 33–39.
6. ACTIVE Investigators, Connolly S.J., Pogue J. et al. Effect of clopidogrel added to aspirin in patients with atrial fibrillation // N. Engl. J. Med.– 2009. – Vol. 360. – P. 2066–2078.
7. Beil W., Sewing K.F., Kromer W. Basic aspects of selectivity of pantoprazole and its pharmacological actions // Drugs Today. – 1999. – Vol. 35, N 10. – P. 753–64.
8. Brunner G., Athmann C., Schneider A. Long-term, openlabel trial: safety and efficacy of continuous maintenance treatment with pantoprazole for up to 15 years in severe acid-peptic disease // Aliment. Pharmacol. Ther. – 2012. – Vol. 36, N 1. – P. 37–47.
9. Chan F.K. Anti-platelet therapy and managing ulcerrisk // J. Gastroenterol. Hepatol. – 2012. – Vol. 27, N 2. – P. 195–199.
10. Chan F., Ching J., Suen B. et al. H. pylori eradication on the long-term incidence of recurrent ulcer bleeding in high-tisk aspirin users: a 10-year prospective cohort study // Gastroenterology. – 2011. – Vol. 140 (suppl.) – P. 173–174.
11. Derry Sh., Loke Y. Risk of gastrointestinal haemorrhage with long term use of aspirin: meta-analysis // BMJ. – 2000. – Vol. 321. – P. 1183–1187.
12. Ford A.C., Delaney B., Forman D., Moayyedi P. Eradication therapy for peptic ulcer disease in Helicobacter pylori positive patients. Cochrane Database of Systematic Reviews 2006, Issue 2. Art. No.: CD003840. DOI: 10.1002/14651858.CD003840.pub4.
13. Gisbert J.P., Khorrami S., Carballo F. et al. Helicobacter pylori eradication therapy vs. antisecretory non-eradication therapy (with or without long-term maintenance antisecretory therapy) for the prevention of recurrent bleeding from peptic ulcer. Cochrane Database of Systematic Reviews 2004, Issue 2. Art. No.: CD004062. DOI: 10.1002/14651858.CD004062.pub2.
14. Huang J.Q., Sridhar S., Hunt R.H. Role of Helicobacter pylori infection and non-steroidal anti-inflammatory drugs in peptic ulcer disease: a meta-analysis // Lancet. – 2002. – Vol. 359. – P. 14–22.
15. Kang G.M., Kim N., Lee B.H. et al. Risk factors for peptic ulcer bleeding in terms of Helicobacter pylori, NSAIDs and antiplatelet agents // Scand. J. Gastroenterol. –2011. – Vol. 46. – P. 1295–1301.
16. Kwok C.S., Jeevanantham V., Dawn B., Loke Y.K. No consistent evidence of differential cardiovascular risk amongst proton-pump inhibitors when used with clopidogrel: a meta-analysis // Int. J. Cardiol. – 2012.
17. Lanza F.L., Chan F., Quigley E. et al. Guidelines for prevention of NSAID-related ulcer complications // Am. J. Gastroenterol. – 2009. – Vol. 104. – P. 728–738.
18. Lim Yu.J., Lee J.S., Ku Ya.S., Hahm K.B. Rescue strategies against nonsteroidal anti-inflammatory drug-induced gastroduodenal damage // J. Gastroenterol. Hepatol. – 2009. – Vol. 24. – P. 1169–1178.
19. Malfertheiner P., Megraud F., O′Morain C. et al. Current concept in the management of Helicobacter pylori infection: the Maastricht III Consensus Report // Gut. – 2007. – Vol. 56. – P. 772–781.
20. Malfertheiner P., Megraud F., O′Morain C. et al. Management of Helicobacter pylori infection – the Maastricht IV / Florence Consensus Report // Gut. – 2012. – Vol. 61. – P. 646–664.
21. Ng F.H., Wong S.Y., Lam K.F. et al. Famotidine is inferior to pantoprazole in preventing recurrence of aspirin-related peptic ulcers or erosions // Gastroenterology. – 2010. – Vol. 138, N 1. – P. 82–88.
22. Rainsford K.D. Anti-inflammatory drugs in the 21st century // Subcell. Biochem. – 2007. – Vol. 42. – P. 3–27.
23. Scarpignato C., Hunt R.H. Nonsteroidal antiinflammatory drug-related injury to the gastrointestinal tract: clinical picture, pathogenesis, and prevention // Gastroenterol. Clin. North. Am. – 2010. – Vol. 39. – P. 433–464.
24. Silverstein F.E., Faich G., Goldstein J.L. et al. Gastrointestinal toxicity with celecoxib vs nonsteroidal anti-inflammatory drugs for osteoarthritis and rheumatoid arthritis // JAMA. – 2000. – Vol. 284. – P. 1247–1255.
25. Singh G., Triadafilopoulos G. Appropriate choice of proton pump inhibitor therapy in the prevention and management of NSAID-related gastrointestinal damage // Int. J. Clin. Pract. 2005. – Vol. 59, N 10. – P. 1210–1217.
26. Steinijans V.W., Huber R., Hartmann M. et al. Lack of pantoprazole drug interactions in man: an updated review // Int. J. Clin. Pharmacol. Ther. – 1996. – Vol. 34 (suppl. 1) – P. 31–50.
27. Tang Ch.-L., Ye F., Wei Liu W. et al. Eradication of Helicobacter pylori infection reduces the incidence of peptic ulcer disease in patients using nonsteroidal antiinflammatory drugs: a meta-analysis // Helicobacter. – 2012. – Vol. 17. – P. 286–296.
28. Vergara M., Catalán M., Gisbert J.P., Calvet X. Metaanalysis: role of Helicobacter pylori eradication in the prevention of peptic ulcer in NSAID users // Aliment. Pharmacol. Ther. – 2005. – Vol. 21, N 12. – P. 1411– 1418.
29. Zelickson M.S., Bronder C.M., Johnson B.L. et al. Helicobacter pylori is not the predominant etiology for peptic ulcer requiring operation // Am. Surg. – 2011. – Vol. 77. – P. 1054–1060.
Review
For citations:
Ivashkin V.T., Lapina T.L. H. pylori eradication therapy for patients receiving nonsteroid antiinflammatory drugs. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2012;22(6):59-65. (In Russ.)
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