[Efficacy of antihelicobacter therapy in NSAID-induced gastropathies]

The aim was to evaluate antihelicobacter therapy in the treatment and prophylaxis of NSAID-induced gastropathy recurrences in patients with rheumatic diseases (RD). 66 patients with RD (58 females and 8 males, mean age 53.6 +/- 12.6 years) participated in the study. They met the following criteria: the presence of ulcers or multiple (more than 10) erosions of gastric or duodenal erosions, administration of nonsteroid anti-inflammatory drugs, Helicobacter pylori (HP) in gastric mucosa biopsies. The patients were randomized into two groups matched by sex, features of RD, antirheumatic therapy, history of ulcer, GIT disease. All the patients received omeprazol in a dose 40 mg/day. Patients of group 1 took also amoxicillin (1 g/day) and klarythromycin (0.5 g/day) for 10 days. Group 2 was control. EGDS was conducted 2, 4 weeks and 6 months after the treatment. HP eradication and dynamics of morphological changes were examined in biopsies of the antral gastric mucosa and mucosa of gastric body. The efficacy of 4-week treatment (ulcer scarring and epithelization of erosions), rate of ulcer recurrences and erosions 6 months after treatment were compared. The efficacy of the treatment was 88 and 95% in group 1 and 2, respectively. HP eradication was achieved in 88% of patients of group 1. In 6 months, recurrences arose in 50 and 48.3% of patients of groups 1 and 2, HP was detected in 22% of patients of group 1. Morphological changes in group 1 patients was characterized by alleviation of chronic active gastritis. HP eradication does not raise the efficacy of the treatment and does not lower the risk of recurrences in patients with NSAID-induced gastropathies. Active chronic gastritis is not the background for recurrences of NSAID-induced gastropathy.