The effect of Helicobacter pylori eradication on the morphological state of the gastric mucosa in patients with rheumatoid arthritis who have been taking nonsteroidal anti-inflammatory drugs for a long time
Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
Vestnik VGMU. 2019;18(1):30-38.
Objectives. To make a prospective evaluation of the effect of Helicobacter pylori (H. pylori) eradication on the gastric mucosa (GM) in patients with rheumatoid arthritis (RA) who have been taking nonsteroidal anti-inflammatory drugs (NSAIDs) for a long time.
Material and methods. The study included 116 patients with RA and with H. pylori infection, who took NSAIDs for a long time. Two groups were formed by means of randomization: a group of patients who underwent H. pylori eradication (57 persons); and a comparison group (59 subjects), in which eradication therapy was not used. The follow-up examination to identify endoscopic signs of gastropathy induced the intake of NSAIDs (NSAID-gastropathy) after the provided treatment was conducted in 45 patients who received eradication therapy and in 16 patients from the comparison group in 0,50 (0,25; 0,91) a year.
Results. The frequency of successful H. pylori eradication in patients with RA who had been taking NSAIDs for a long time made up 82,2%. Patients with successful H. pylori eradication demonstrated a statistically significant decrease in the indices of activity (p<0,001), inflammation (p<0,001) and atrophy (р=0,017) in the GM of the antrum and that in the indices of activity (p<0,001) and inflammation (p<0,001) in the GM of the fundus of the stomach. In the comparison group, where eradication therapy hadn’t been provided, no statistically significant differences in the morphological parameters of the gastric mucosa were revealed.
Conclusions. Successful eradication of the H. pylori microorganism in patients with RA, who had been taking NSAIDs for a long time and continued to take them in the future, was accompanied by a positive dynamics of the GM morphological parameters.
Key words: rheumatoid arthritis, nonsteroidal anti-inflammatory drugs, eradication, Helicobacter pylori.
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Information about authors:
Dikareva E.A .– Candidate of Medical Sciences, associate professor of the General Practitioner Chair with the course of Outpatient Therapy, Vitebsk State Order of Peoples’ Friendship Medical University.