Randomized study of Helicobacter pylori eradication therapy and proton pump inhibitor monotherapy for idiopathic thrombocytopenic purpura

Tsutsumi, Yutaka; Kanamori, Hiroe; Yamato, Hiroaki; Ehira, Nobuyuki; Κawamura, Toshiyuki; Umehara, Shintaro; Mori, Akio; Obara, Shin’ya; Ogura, Nobutaka; Tanaka, Junji; Asaka, Masahiro; Imamura, Masahiro; Masauzi, Nobuo

doi:10.1007/s00277-005-1071-z

Cited by 33 publications

(20 citation statements)

References 21 publications

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“…Th ere is evidence from small randomized and non-randomized trials for a sustained improvement in platelet counts aft er eradication of H. pylori infection in a proportion of adult patients with ITP (75)(76)(77). Th e evidence is less compelling for children with ITP ( 78 ).…”

Section: Idiopathic Thrombocytopenic Purpura (Itp)mentioning

confidence: 99%

ACG Clinical Guideline: Treatment of Helicobacter pylori Infection

Chey

Leontiadis

Howden

et al. 2017

American Journal of Gastroenterology

1,316

1,505

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Helicobacter pylori ( H. pylori ) infection is a common worldwide infection that is an important cause of peptic ulcer disease and gastric cancer. H. pylori may also have a role in uninvestigated and functional dyspepsia, ulcer risk in patients taking low-dose aspirin or starting therapy with a non-steroidal anti-infl ammatory medication, unexplained iron defi ciency anemia, and idiopathic thrombocytopenic purpura. While choosing a treatment regimen for H. pylori , patients should be asked about previous antibiotic exposure and this information should be incorporated into the decision-making process. For fi rst-line treatment, clarithromycin triple therapy should be confi ned to patients with no previous history of macrolide exposure who reside in areas where clarithromycin resistance amongst H. pylori isolates is known to be low. Most patients will be better served by fi rst-line treatment with bismuth quadruple therapy or concomitant therapy consisting of a PPI, clarithromycin, amoxicillin, and metronidazole. When fi rst-line therapy fails, a salvage regimen should avoid antibiotics that were previously used. If a patient received a fi rst-line treatment containing clarithromycin, bismuth quadruple therapy or levofl oxacin salvage regimens are the preferred treatment options. If a patient received fi rst-line bismuth quadruple therapy, clarithromycin or levofl oxacin-containing salvage regimens are the preferred treatment options. Details regarding the drugs, doses and durations of the recommended and suggested fi rst-line and salvage regimens can be found in the guideline. Asia and Central and South America ( 8,22 ). Th ere is, however, preliminary evidence that it may be falling in some previously high prevalence areas ( 22 ). People immigrating to North America from Asia and other parts of the world have a much higher prevalence of the infection than people born in North America ( 23 ). In one study, the seroprevalence among immigrants from East Asia was 70.1% ( 24 ). Hispanic immigrants to North America have higher rates of the infection than fi rst-or second-generation Hispanics who were born here ( 25 ). QUESTION 2: WHAT ARE THE INDICATIONS TO TEST FOR, AND TO TREAT, H. PYLORI INFECTION? RecommendationsSince all patients with a positive test of active infection with H. pylori should be off ered treatment, the critical issue is which patients should be tested for the infection (strong recommendation, quality of evidence: not applicable), All patients with active peptic ulcer disease (PUD), a past history of PUD (unless previous cure of H. pylori infection has been documented), low-grade gastric mucosa-associated lymphoid tissue (MALT) lymphoma, or a history of endoscopic resection of early gastric cancer (EGC) should be tested for H. pylori infection. Th ose who test positive should be off ered treatment for the infection (strong recommendation, quality of evidence: high for active or history of PUD, low for MALT lymphoma, low for history of endoscopic resection of EGC).In patients with uninvestigated d...

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Section: Idiopathic Thrombocytopenic Purpura (Itp)mentioning

confidence: 99%

ACG Clinical Guideline: Treatment of Helicobacter pylori Infection

Chey

Leontiadis

Howden

et al. 2017

American Journal of Gastroenterology

1,316

1,505

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“…218 Studies have also shown that there is a significant increase in platelet count in patients with ITP after H. Pylori eradication. 220,222,223,224 Prevention of gastric cancer ACG recommends H. Pylori testing after endoscopic resection of early gastric cancer. EHSG recommends H. Pylori testing and eradication in first-degree relatives of patients with gastric cancer.…”

Section: Chronic Itpmentioning

confidence: 99%

Helicobacter Pylori Infection in Peptic Ulcer Disease

Tsang¹,

Shrestha²

2011

Peptic Ulcer Disease

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“…Patients receiving corticosteroids, antibiotics and immunosuppressive drugs were excluded. Because proton-pump inhibitors [19,20] and non-steroidal anti-inflammatory drugs [21,22,23,24,25,26] could alter the cytokine profile, patients receiving proton-pump inhibitors or non-steroidal anti-inflammatory drugs were also excluded. Smoking habit had been reported to upregulate peripheral platelet counts [7,8,9], and thus, current smokers were excluded.…”

Section: Methodsmentioning

confidence: 99%

<i>Helicobacter pylori</i> Upregulates Peripheral Platelet Counts Mainly in Female Patients

Matsukawa

Kitamura

Iwamoto³

et al. 2011

Acta Haematol

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To evaluate the influence of Helicobacter pylori and sex difference on peripheral platelet counts, dyspeptic patients without immunohaematologic disorders were evaluated. H. pylori infection was verified with the rapid urease test and serum anti-H. pylori IgG antibody. Platelet counts were analysed with a reference to H. pylori infection and sex difference. Among H. pylori-eradicated patients, changes in platelet counts were separately evaluated. Totally, 655 patients were enrolled: 340 patients were infected with H. pylori and 178 patients received eradication therapy, with a success rate of 88.2% (157/178). Females with H. pylori infection definitely manifested elevated platelet counts (infected vs. uninfected 244 ± 57 vs. 219 ± 54 × 10⁹/l; p < 0.0001). H. pylori eradication reduced peripheral platelets by 8 weeks, 5–6 months, 1, 2 and ≧3 years after eradication in females from 248 ± 54 to 237 ± 49, 237 ± 54, 229 ± 48, 238 ± 61 and 232 ± 50 × 10⁹/l (p = 0.0003, 0.0182, 0.0041, 0.0398 and 0.0289), respectively. In males, the reduction was verified by 8 weeks, 1 year and ≧3 years from 226 ± 52 to 217 ± 47, 214 ± 44 and 200 ± 49 × 10⁹/l (p = 0.0464, 0.0164 and 0.0016), respectively. In conclusion, H. pylori infection upregulates platelet counts mainly in females, and eradication reduced peripheral platelets in both sexes. Females appeared more susceptible to H. pylori infection than males with regard to upregulation of platelet counts.

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Randomized study of Helicobacter pylori eradication therapy and proton pump inhibitor monotherapy for idiopathic thrombocytopenic purpura

Cited by 33 publications

References 21 publications

ACG Clinical Guideline: Treatment of Helicobacter pylori Infection

ACG Clinical Guideline: Treatment of Helicobacter pylori Infection

Helicobacter Pylori Infection in Peptic Ulcer Disease

<i>Helicobacter pylori</i> Upregulates Peripheral Platelet Counts Mainly in Female Patients

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