Clinical Trial: Prolonged beneficial effect of Helicobacter pylori eradication on dyspepsia consultations - the Bristol Helicobacter Project
Résumé
Background Helicobacter pylori infection is the major cause of peptic ulcer disease and gastric cancer. Short-term benefit results from community programmes to eradicate the infection, but there is little information on cumulative long-term benefit. Aim To determine whether a community programme of eradication of Helicobacter pylori infection produces further benefit after an initial two-year period. Methods 1,517 people with Helicobacter pylori infection were entered into a randomised double-blind trial of H. pylori eradication therapy. After two years, we found a 35% reduction in GP consultations for dyspepsia (previously reported). In this extension to the study, we analysed dyspepsia consultations between two and seven years after treatment. Results Between two and seven years after treatment, 81/764 (10.6%) of participants randomised to receive active treatment consulted for dyspepsia, compared with 106/753 (14.1%) of those who received placebo, a 25% reduction, odds ratio 0.84 (0.71,1.00), p = 0.042. Conclusions Eradication of H. pylori infection in the community gives cumulative long-term benefit. The cost savings resulting from this aspect of a community H. pylori eradication programme, in addition to the other theoretical benefits, make such programmes worthy of serious consideration, particularly in populations with a high prevalence of H. pylori infection.
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