NSAIDs and H. pylori: A Dangerous Combination?

Screening and treatment for H. pylori infection before initiating NSAID therapy may reduce risk for ulcers, but may not be as compelling in populations in whom the prevalence of H. pylori is decreasing.

Helicobacter pylori infection and nonsteroidal anti-inflammatory drugs (NSAIDs) are independently associated with peptic ulcer disease, but the potential interaction between these factors is controversial. Large, population-based studies have failed to identify a synergistic effect, whereas results from cohort studies suggest both an additive risk and a protective effect associated with H. pylori infection and NSAID use. To examine whether H. pylori eradication reduces ulceration in patients taking NSAIDs, investigators in Hong Kong randomized 100 arthritis patients with H. pylori infection who were about to take NSAIDs for the first time to receive either 1 week of omeprazole-based antibiotic therapy for H. pylori or omeprazole plus placeb…

Reviewing Author

David J. Bjorkman, MD, MSPH, SM (Epid.)