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Efficacy and safety of Helicobacter pylori eradication therapy immediately after endoscopic submucosal dissection
Author(s) -
Takahashi Yoshiaki,
Takeuchi Toshihisa,
Kojima Yuichi,
Nagami Yasuaki,
Ominami Masaki,
Uedo Noriya,
Hamada Kenta,
Suzuki Haruhisa,
Oda Ichiro,
Miyaoka Youichi,
Yamanouchi Satoshi,
Tokioka Satoshi,
Tomatsuri Naoya,
Yoshida Norimasa,
Naito Yuji,
aka Takashi,
Kodashima Shinya,
Ogata Shinichi,
Hongo Yasushi,
Oshima Tadayuki,
Li Zhaoliang,
Shibagaki Kotaro,
Oikawa Tomoyuki,
Tominaga Kazunari,
Higuchi Kazuhide
Publication year - 2018
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.14073
Subject(s) - medicine , helicobacter pylori , proton pump inhibitor , endoscopic submucosal dissection , gastroenterology , surgery , adverse effect , confidence interval
Background and Aims In the treatment of patients after endoscopic submucosal dissection (ESD), there is no consensus on the optimum time to start Helicobacter pylori eradication therapy or on whether eradication therapy improves ulcer healing rate after ESD. The aim of this study was to examine the effect of immediate eradication of H. pylori on ulcer healing after ESD in patients with early gastric neoplasms. Methods A total of 330 patients who underwent ESD for early gastric neoplasms were enrolled. Patients were assigned to either H. pylori eradication group (Group A: H. pylori eradication + proton pump inhibitor 7 weeks) or non‐eradication group (Group B: proton pump inhibitor 8 weeks). The primary end point was gastric ulcer healing rate (Group A vs Group B) determined on week 8 after ESD. Results Patients in Group A failed to meet non‐inferiority criteria for ulcer scarring rate after ESD compared with that in Group B (83.0% vs 86.5%, P for non‐inferiority = 0.0599, 95% confidence interval: −11.7% to 4.7%). There were, however, neither large differences between the two groups in the ulcer scarring rate nor the safety profile. Conclusions This study failed to demonstrate the non‐inferiority of immediate H. pylori eradication therapy after ESD to the non‐eradication therapy in the healing rate of ESD‐caused ulcers. However, because the failure is likely to attribute to small number of patients enrolled, immediate eradication therapy may be a treatment option for patients after ESD without adverse effects on eradication therapy in comparison with the standard therapy.