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Helicobacter pylori infection and development of gastric or duodenal ulcer in arthritic patients receiving chronic NSAID therapy. The Misoprostol Study Group.

OBJECTIVES
Helicobacter pylori infection and nonsteroidal anti-inflammatory drug use are both common causes of peptic ulcer. It remains unclear whether H. pylori/NSAID interactions occur, and if they do, with what result(s).


METHODS
We prospectively evaluated development of gastric or duodenal ulcers in 181 arthritics followed for up to 3 months while receiving an NSAID chronically and with no active anti-ulcer medications. H. pylori status was determined with a sensitive, specific ELISA for anti-H. pylori IgG.


RESULTS
H. pylori infection was present in 51%; peptic ulcers developed in 24. H. pylori infection was present in only 36% of those who developed a duodenal ulcer. Stepwise logistic regression analysis indicated none of the variable factors of age, gender, alcohol consumption, type of arthritis, or H. pylori status were significantly associated with development of peptic ulceration.


CONCLUSIONS
These data suggest that H. pylori does not confer increased risk of ulceration in arthritics receiving NSAIDs chronically.