AustralieFrV1, Main, Exploration, bibRecord, 00A829

Cure of Helicobacter pylori infection in patients with reflux oesophagitis treated with long term omeprazole reverses gastritis without exacerbation of reflux disease: results of a randomised controlled trial

Identifieur interne : 00A829 ( Main/Exploration ); précédent : 00A828; suivant : 00A830

Cure of Helicobacter pylori infection in patients with reflux oesophagitis treated with long term omeprazole reverses gastritis without exacerbation of reflux disease: results of a randomised controlled trial

Auteurs : E J Kuipers [Pays-Bas] ; G F Nelis [Pays-Bas] ; E C Klinkenberg-Knol [Pays-Bas] ; P. Snel [Pays-Bas] ; D. Goldfain [France] ; J J Kolkman [Pays-Bas] ; H P M. Festen [Pays-Bas] ; J. Dent [Australie] ; P. Zeitoun [France] ; N. Havu [Suède] ; M. Lamm [Suède] ; A. Walan [Suède]

Source :

Gut [ 0017-5749 ] ; 2004.

RBID : PMC:1773939

Abstract

Background: Helicobacter pylori gastritis may progress to glandular atrophy and intestinal metaplasia, conditions that predispose to gastric cancer. Profound suppression of gastric acid is associated with increased severity of H pylori gastritis. This prospective randomised study aimed to investigate whether H pylori eradication can influence gastritis and its sequelae during long term omeprazole therapy for gastro-oesophageal reflux disease (GORD).

Methods: A total of 231 H pylori positive GORD patients who had been treated for ⩾12 months with omeprazole maintenance therapy (OM) were randomised to either continuation of OM (OM only; n = 120) or OM plus a one week course of omeprazole, amoxycillin, and clarithromycin (OM triple; n = 111). Endoscopy with standardised biopsy sampling as well as symptom evaluation were performed at baseline and after one and two years. Gastritis was assessed according to the Sydney classification system for activity, inflammation, atrophy, intestinal metaplasia, and H pylori density.

Results: Corpus gastritis activity at entry was moderate or severe in 50% and 55% of the OM only and OM triple groups, respectively. In the OM triple group, H pylori was eradicated in 90 (88%) patients, and activity and inflammation decreased substantially in both the antrum and corpus (p<0.001, baseline v two years). Atrophic gastritis also improved in the corpus (p<0.001) but not in the antrum. In the 83 OM only patients with continuing infection, there was no change in antral and corpus gastritis activity or atrophy, but inflammation increased (p<0.01). H pylori eradication did not alter the dose of omeprazole required, or reflux symptoms.

Conclusions: Most H pylori positive GORD patients have a corpus predominant pangastritis during omeprazole maintenance therapy. Eradication of H pylori eliminates gastric mucosal inflammation and induces regression of corpus glandular atrophy. H pylori eradication did not worsen reflux disease or lead to a need for increased omeprazole maintenance dose. We therefore recommend eradication of H pylori in GORD patients receiving long term acid suppression.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1773939

PubMed: 14684569
PubMed Central: 1773939

Affiliations:

Le document en format XML

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 infection in patients with reflux oesophagitis treated with long term omeprazole reverses gastritis without exacerbation of reflux disease: results of a randomised controlled trial</title>
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<settlement type="city">Reims</settlement>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Cure of <italic>Helicobacter pylori</italic>
 infection in patients with reflux oesophagitis treated with long term omeprazole reverses gastritis without exacerbation of reflux disease: results of a randomised controlled trial</title>
<author><name sortKey="Kuipers, E J" sort="Kuipers, E J" uniqKey="Kuipers E" first="E J" last="Kuipers">E J Kuipers</name>
<affiliation wicri:level="3"><nlm:aff id="aff1">Department of Gastroenterology and Hepatology, Erasmus MC University Medical Centre, Rotterdam, the Netherlands</nlm:aff>
<country xml:lang="fr" wicri:curation="lc">Pays-Bas</country>
<wicri:regionArea>Department of Gastroenterology and Hepatology, Erasmus MC University Medical Centre, Rotterdam</wicri:regionArea>
<placeName><settlement type="city">Rotterdam</settlement>
<region nuts="2" type="province">Hollande-Méridionale</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Nelis, G F" sort="Nelis, G F" uniqKey="Nelis G" first="G F" last="Nelis">G F Nelis</name>
<affiliation wicri:level="1"><nlm:aff id="aff2">Department of Gastroenterology, Sophia Hospital, Zwolle, the Netherlands</nlm:aff>
<country xml:lang="fr" wicri:curation="lc">Pays-Bas</country>
<wicri:regionArea>Department of Gastroenterology, Sophia Hospital, Zwolle</wicri:regionArea>
<wicri:noRegion>Zwolle</wicri:noRegion>
</affiliation>
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<author><name sortKey="Klinkenberg Knol, E C" sort="Klinkenberg Knol, E C" uniqKey="Klinkenberg Knol E" first="E C" last="Klinkenberg-Knol">E C Klinkenberg-Knol</name>
<affiliation wicri:level="3"><nlm:aff id="aff3">Department of Gastroenterology, Free University Hospital, Amsterdam, the Netherlands</nlm:aff>
<country xml:lang="fr" wicri:curation="lc">Pays-Bas</country>
<wicri:regionArea>Department of Gastroenterology, Free University Hospital, Amsterdam</wicri:regionArea>
<placeName><settlement type="city">Amsterdam</settlement>
<region nuts="2" type="province">Hollande-Septentrionale</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Snel, P" sort="Snel, P" uniqKey="Snel P" first="P" last="Snel">P. Snel</name>
<affiliation wicri:level="3"><nlm:aff id="aff4">Department of Gastroenterology, Slotervaart Hospital, Amsterdam, the Netherlands</nlm:aff>
<country xml:lang="fr" wicri:curation="lc">Pays-Bas</country>
<wicri:regionArea>Department of Gastroenterology, Slotervaart Hospital, Amsterdam</wicri:regionArea>
<placeName><settlement type="city">Amsterdam</settlement>
<region nuts="2" type="province">Hollande-Septentrionale</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Goldfain, D" sort="Goldfain, D" uniqKey="Goldfain D" first="D" last="Goldfain">D. Goldfain</name>
<affiliation wicri:level="3"><nlm:aff id="aff5">Department of Gastroenterology, Hopital Victor Jusselin, Dreux, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Department of Gastroenterology, Hopital Victor Jusselin, Dreux</wicri:regionArea>
<placeName><region type="region">Centre-Val de Loire</region>
<region type="old region">Région Centre</region>
<settlement type="city">Dreux</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Kolkman, J J" sort="Kolkman, J J" uniqKey="Kolkman J" first="J J" last="Kolkman">J J Kolkman</name>
<affiliation wicri:level="1"><nlm:aff id="aff6">Department of Gastroenterology, Medical Spectrum Twente, Enschede, the Netherlands</nlm:aff>
<country xml:lang="fr" wicri:curation="lc">Pays-Bas</country>
<wicri:regionArea>Department of Gastroenterology, Medical Spectrum Twente, Enschede</wicri:regionArea>
<wicri:noRegion>Enschede</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Festen, H P M" sort="Festen, H P M" uniqKey="Festen H" first="H P M" last="Festen">H P M. Festen</name>
<affiliation wicri:level="1"><nlm:aff id="aff7">Department of Gastroenterology, Groot Ziekengasthuis, Den Bosch, the Netherlands</nlm:aff>
<country xml:lang="fr" wicri:curation="lc">Pays-Bas</country>
<wicri:regionArea>Department of Gastroenterology, Groot Ziekengasthuis, Den Bosch</wicri:regionArea>
<wicri:noRegion>Den Bosch</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Dent, J" sort="Dent, J" uniqKey="Dent J" first="J" last="Dent">J. Dent</name>
<affiliation wicri:level="1"><nlm:aff id="aff8">Department of Gastroenterology, Royal Adelaide Hospital, Adelaide, Australia</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Department of Gastroenterology, Royal Adelaide Hospital, Adelaide</wicri:regionArea>
<wicri:noRegion>Adelaide</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Zeitoun, P" sort="Zeitoun, P" uniqKey="Zeitoun P" first="P" last="Zeitoun">P. Zeitoun</name>
<affiliation wicri:level="3"><nlm:aff id="aff9">Department of Gastroenterology, Hopital Robert Derbre, Reims, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Department of Gastroenterology, Hopital Robert Derbre, Reims</wicri:regionArea>
<placeName><region type="region">Grand Est</region>
<region type="old region">Champagne-Ardenne</region>
<settlement type="city">Reims</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Havu, N" sort="Havu, N" uniqKey="Havu N" first="N" last="Havu">N. Havu</name>
<affiliation wicri:level="1"><nlm:aff id="aff10">AstraZeneca R&D, Södertalje, Sweden</nlm:aff>
<country xml:lang="fr">Suède</country>
<wicri:regionArea>AstraZeneca R&D, Södertalje</wicri:regionArea>
<wicri:noRegion>Södertalje</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Lamm, M" sort="Lamm, M" uniqKey="Lamm M" first="M" last="Lamm">M. Lamm</name>
<affiliation wicri:level="1"><nlm:aff id="aff11">AstraZeneca R&D, Mölndal, Sweden</nlm:aff>
<country xml:lang="fr">Suède</country>
<wicri:regionArea>AstraZeneca R&D, Mölndal</wicri:regionArea>
<wicri:noRegion>Mölndal</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Walan, A" sort="Walan, A" uniqKey="Walan A" first="A" last="Walan">A. Walan</name>
<affiliation wicri:level="1"><nlm:aff id="aff11">AstraZeneca R&D, Mölndal, Sweden</nlm:aff>
<country xml:lang="fr">Suède</country>
<wicri:regionArea>AstraZeneca R&D, Mölndal</wicri:regionArea>
<wicri:noRegion>Mölndal</wicri:noRegion>
</affiliation>
</author>
</analytic>
<series><title level="j">Gut</title>
<idno type="ISSN">0017-5749</idno>
<idno type="eISSN">1458-3288</idno>
<imprint><date when="2004">2004</date>
</imprint>
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<front><div type="abstract" xml:lang="en"><p><bold>Background:</bold>
 <italic>Helicobacter pylori</italic>
 gastritis may progress to glandular atrophy and intestinal metaplasia, conditions that predispose to gastric cancer. Profound suppression of gastric acid is associated with increased severity of <italic>H pylori</italic>
 gastritis. This prospective randomised study aimed to investigate whether <italic>H pylori</italic>
 eradication can influence gastritis and its sequelae during long term omeprazole therapy for gastro-oesophageal reflux disease (GORD).</p>
<p><bold>Methods:</bold>
 A total of 231 <italic>H pylori</italic>
 positive GORD patients who had been treated for ⩾12 months with omeprazole maintenance therapy (OM) were randomised to either continuation of OM (OM only; n = 120) or OM plus a one week course of omeprazole, amoxycillin, and clarithromycin (OM triple; n = 111). Endoscopy with standardised biopsy sampling as well as symptom evaluation were performed at baseline and after one and two years. Gastritis was assessed according to the Sydney classification system for activity, inflammation, atrophy, intestinal metaplasia, and <italic>H pylori</italic>
 density.</p>
<p><bold>Results:</bold>
 Corpus gastritis activity at entry was moderate or severe in 50% and 55% of the OM only and OM triple groups, respectively. In the OM triple group, <italic>H pylori</italic>
 was eradicated in 90 (88%) patients, and activity and inflammation decreased substantially in both the antrum and corpus (p<0.001, baseline <italic>v</italic>
 two years). Atrophic gastritis also improved in the corpus (p<0.001) but not in the antrum. In the 83 OM only patients with continuing infection, there was no change in antral and corpus gastritis activity or atrophy, but inflammation increased (p<0.01). <italic>H pylori</italic>
 eradication did not alter the dose of omeprazole required, or reflux symptoms.</p>
<p><bold>Conclusions:</bold>
 Most <italic>H pylori</italic>
 positive GORD patients have a corpus predominant pangastritis during omeprazole maintenance therapy. Eradication of <italic>H pylori</italic>
 eliminates gastric mucosal inflammation and induces regression of corpus glandular atrophy. <italic>H pylori</italic>
 eradication did not worsen reflux disease or lead to a need for increased omeprazole maintenance dose. We therefore recommend eradication of <italic>H pylori</italic>
 in GORD patients receiving long term acid suppression.</p>
</div>
</front>
</TEI>
<affiliations><list><country><li>Australie</li>
<li>France</li>
<li>Pays-Bas</li>
<li>Suède</li>
</country>
<region><li>Centre-Val de Loire</li>
<li>Champagne-Ardenne</li>
<li>Grand Est</li>
<li>Hollande-Méridionale</li>
<li>Hollande-Septentrionale</li>
<li>Région Centre</li>
</region>
<settlement><li>Amsterdam</li>
<li>Dreux</li>
<li>Reims</li>
<li>Rotterdam</li>
</settlement>
</list>
<tree><country name="Pays-Bas"><region name="Hollande-Méridionale"><name sortKey="Kuipers, E J" sort="Kuipers, E J" uniqKey="Kuipers E" first="E J" last="Kuipers">E J Kuipers</name>
</region>
<name sortKey="Festen, H P M" sort="Festen, H P M" uniqKey="Festen H" first="H P M" last="Festen">H P M. Festen</name>
<name sortKey="Klinkenberg Knol, E C" sort="Klinkenberg Knol, E C" uniqKey="Klinkenberg Knol E" first="E C" last="Klinkenberg-Knol">E C Klinkenberg-Knol</name>
<name sortKey="Kolkman, J J" sort="Kolkman, J J" uniqKey="Kolkman J" first="J J" last="Kolkman">J J Kolkman</name>
<name sortKey="Nelis, G F" sort="Nelis, G F" uniqKey="Nelis G" first="G F" last="Nelis">G F Nelis</name>
<name sortKey="Snel, P" sort="Snel, P" uniqKey="Snel P" first="P" last="Snel">P. Snel</name>
</country>
<country name="France"><region name="Centre-Val de Loire"><name sortKey="Goldfain, D" sort="Goldfain, D" uniqKey="Goldfain D" first="D" last="Goldfain">D. Goldfain</name>
</region>
<name sortKey="Zeitoun, P" sort="Zeitoun, P" uniqKey="Zeitoun P" first="P" last="Zeitoun">P. Zeitoun</name>
</country>
<country name="Australie"><noRegion><name sortKey="Dent, J" sort="Dent, J" uniqKey="Dent J" first="J" last="Dent">J. Dent</name>
</noRegion>
</country>
<country name="Suède"><noRegion><name sortKey="Havu, N" sort="Havu, N" uniqKey="Havu N" first="N" last="Havu">N. Havu</name>
</noRegion>
<name sortKey="Lamm, M" sort="Lamm, M" uniqKey="Lamm M" first="M" last="Lamm">M. Lamm</name>
<name sortKey="Walan, A" sort="Walan, A" uniqKey="Walan A" first="A" last="Walan">A. Walan</name>
</country>
</tree>
</affiliations>
</record>

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Cure of Helicobacter pylori infection in patients with reflux oesophagitis treated with long term omeprazole reverses gastritis without exacerbation of reflux disease: results of a randomised controlled trial

Cure of Helicobacter pylori infection in patients with reflux oesophagitis treated with long term omeprazole reverses gastritis without exacerbation of reflux disease: results of a randomised controlled trial

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	Serveur d'exploration sur les relations entre la France et l'Australie
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