Is Helicobacter pylori eradication useful in patients taking NSAIDs?

It has become clear that Helicobacter pylori and non-steroidal anti-inflammatory drugs (NSAIDs) account for the vast majority of peptic ulcers and their complications. Although gastric or duodenal ulceration caused by H. pylori or NSAIDs is very similar, the underlying processes are quite different. Given the possibility that H. pylori eradication might represent a valuable approach to the management of patients taking NSAIDs, a controlled clinical trial was performed in patients with current or previous endoscopically documented NSAID-associated gastric or duodenal ulceration and/or moderate-to-severe dyspepsia at study entry. Patients received either H. pylori eradication therapy or omeprazole alone. H. pylori eradication did not prevent ulcer recurrence during a six-month assessment; indeed, it retarded healing of gastric ulcers. The hypothesis that dyspepsia would be prevented by H. pylori eradication was not confirmed either.