Interaction Between NSAIDs and H. pylori in Peptic Ulcer Disease

Helicobacter pylori infection and the use of nonsteroidal anti-inflammatory drugs (NSAIDs) are the most common causes of peptic ulcer disease. The interaction between these risk factors, however, is controversial: Some study results suggest a strong synergistic effect that increases the risk for ulcers, whereas other results suggest that H. pylori infection protects against formation of NSAID-associated ulcers.

To address this controversy, investigators searched MEDLINE, PubMed, and Cochrane databases to identify observational studies that reported independent event rates for peptic ulcer disease and ulcer bleeding in patients taking NSAIDs, in patients with H. pylori infection, or in patients with both risk factors. Manual searches for rele…