Cost-effectiveness of helicobacter pylori (H. pylori) eradication in the long-term management of duodenal ulder

Primary gastric lymphoma (PGL) represents a rare pathology, which can be easily misdiagnosed because of unspecific symptoms of the digestive tract. Histologically, PGL can vary from indolent marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT) to aggressive diffuse large B-cell lymphoma (DLBCL). During the years, clinical trials revealed the important role of Helicobacter pylori (H. pylori) in the pathogenesis of gastric MALT lymphoma. Infection with Helicobacter pylori is an influential promoter of gastric lymphomagenesis initiation. Long-term studies revealed that eradication therapy could regress gastric lymphomas.

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Identification of Markers for Helicobacter pylori Strains Isolated from Children with Peptic Ulcer Disease by Suppressive Subtractive Hybridization

Infection and Immunity ◽

10.1128/iai.00123-06 ◽

2006 ◽

Vol 74 (7) ◽

pp. 4064-4074 ◽

Cited By ~ 34

Author(s):

Mónica Oleastro ◽

Lurdes Monteiro ◽

Philippe Lehours ◽

Francis Mégraud ◽

Armelle Ménard

Keyword(s):

Helicobacter Pylori ◽

Peptic Ulcer ◽

Peptic Ulcer Disease ◽

Subtractive Hybridization ◽

Suppressive Subtractive Hybridization ◽

Ulcer Disease ◽

Lipopolysaccharide Biosynthesis ◽

The Difference ◽

H Pylori

ABSTRACT Peptic ulcer disease (PUD) occurs after a long-term Helicobacter pylori infection. However, the disease can develop earlier, and rare cases have been observed in children, suggesting that these H. pylori strains may be more virulent. We used suppressive subtractive hybridization for comparative genomics between H. pylori strains isolated from a 5-year-old child with duodenal ulcer and from a sex- and age-matched child with gastritis only. The prevalence of the 30 tester-specific subtracted sequences was determined on a collection of H. pylori strains from children (15 ulcers and 30 gastritis) and from adults (46 ulcers and 44 gastritis). Two of these sequences, jhp0562 (80.0% versus 33.3%, P = 0.008) and jhp0870 (80.0% versus 36.7%, P = 0.015), were highly associated with PUD in children and a third sequence, jhp0828, was less associated (40.0% versus 10.0%, P = 0.048). Among adult strains, none of the 30 sequences was associated with PUD. However, both jhp0562 and jhp0870 were less prevalent in adenocarcinoma strains than in PUD strains from children and adults, the difference being statistically significant for jhp0870. In conclusion, two H. pylori genes were identified as being strongly associated with PUD in children, and their putative roles as an outer membrane protein for jhp0870 and in lipopolysaccharide biosynthesis for jhp0562, suggest that they may be novel virulence factors of H. pylori.

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Cost-effectiveness and long-term impact of Helicobacter pylori ???test and treat??? service in reducing open access endoscopy referrals

European Journal of Gastroenterology & Hepatology ◽

10.1097/00042737-200410000-00005 ◽

2004 ◽

Vol 16 (10) ◽

pp. 981-986 ◽

Cited By ~ 8

Author(s):

Aravamuthan Sreedharan ◽

Micheal Clough ◽

Elaine Hemingbrough ◽

Luigi Gatta ◽

Douglas M Chalmers ◽

...

Keyword(s):

Helicobacter Pylori ◽

Cost Effectiveness ◽

Open Access ◽

Test And Treat ◽

Long Term Impact

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Cost-effective Analysis of Proton Pump Inhibitors in Long-term Management of Gastroesophageal Reflux Disease: A Narrative Review

Hospital Pharmacy ◽

10.1177/0018578719893378 ◽

2019 ◽

Vol 55 (5) ◽

pp. 292-305

Author(s):

Shazia Jamshed ◽

Akshaya Srikanth Bhagavathula ◽

Sheikh Muhammad Zeeshan Qadar ◽

Umaira Alauddin ◽

Sana Shamim ◽

...

Keyword(s):

Cost Effectiveness ◽

Gastroesophageal Reflux Disease ◽

Cost Effective ◽

The Other ◽

Cost Effectiveness Ratio ◽

On Demand ◽

Step Down ◽

The Cost ◽

Term Management

Background: Gastroesophageal reflux disease (GERD) is a common gastrointestinal disorder that results from regurgitation of acid from the stomach into the esophagus. Treatment available for GERD includes lifestyle changes, antacids, histamine-2 receptor antagonists (H2RAs), proton pump inhibitors (PPIs), and anti-reflux surgery. Aim: The aim of this review is to assess the cost-effectiveness of the use of PPIs in the long-term management of patients with GERD. Method: We searched in PubMed to identify related original articles with close consideration based on inclusion and exclusion criteria to choose the best studies for this narrative review. The first section compares the cost-effectiveness of PPIs with H2RAs in long-term heartburn management. The other sections shall only discuss the cost-effectiveness of PPIs in 5 different strategies, namely, continuous (step-up, step-down, and maintenance), on-demand, and intermittent therapies. Results: Of 55 articles published, 10 studies published from 2000 to 2015 were included. Overall, PPIs are more effective in relieving heartburn in comparison with ranitidine. The use of PPIs in managing heartburn in long-term consumption of nonsteroidal anti-inflammatory drug (NSAID) has higher cost compared with H2RA. However, if the decision-maker is willing to pay more than US$174 788.60 per extra quality-adjusted life year (QALY), then the optimal strategy is traditional NSAID (tNSAID) and PPIs. The probability of being cost-effective was also highest for NSAID and PPI co-therapy users. On-demand PPI treatment strategy showed dominant with an incremental cost-effectiveness ratio of US$2197 per QALY gained and was most effective and cost saving compared with all the other treatments. The average cost-effectiveness ratio was lower for rabeprazole therapy than for ranitidine therapy. Conclusion: Our review revealed that long-term treatment with PPIs is effective but costly. To achieve long-term cost-effective approach, we recommend on-demand approach to treat heartburn symptoms, but if the symptoms persist, treatment with continuous step-down therapy should be applied.

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RECURRENCE RATE OF HELICOBACTER PYLORI IN PATIENTS WITH PEPTIC ULCER FIVE YEARS OR MORE AFTER SUCCESSFUL ERADICATION

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032016000300006 ◽

2016 ◽

Vol 53 (3) ◽

pp. 152-155 ◽

Cited By ~ 2

Author(s):

Yuri Costa Farago FERNANDES ◽

Gabriel da Rocha BONATTO ◽

Mauro Willeman BONATTO

Keyword(s):

Helicobacter Pylori ◽

Peptic Ulcer ◽

Recurrence Rate ◽

Early Recurrence ◽

Peptic Ulcers ◽

Ulcer Disease ◽

Gastroduodenal Mucosa ◽

H Pylori

ABSTRACT Background Infection with Helicobacter pylori is highly prevalent worldwide, especially in developing countries. Its presence in the gastroduodenal mucosa is related with development of peptic ulcer and other illnesses. The eradication of H. pylori improves mucosal histology in patients with peptic ulcers. Objective This study was aimed to verify if H. pylori recurrence occurs five years or more after confirmed eradication in patients with peptic ulcer. Moreover, we sought to determine the recurrence rate. Methods Retrospective and longitudinal, this study was based on a sample of 201 patients from western Paraná, Brazil. The patients were diagnosed with peptic ulcer disease, in the period of 1990-2000, and followed for five years or more after successful H. pylori eradication. Patients with early recurrence - prior to five years after eradication - were excluded from the sample. Results During an average follow-up of 8 years, 180 patients (89.55%) remained negative, and 21 (10.45%) became positive for H. pylori infection. New ulcers appeared in two-thirds of the patients with H. pylori recurrence. Conclusion The recurrence of H. pylori in patients with peptic ulcer can occur in the long-term - even if the infection had been successfully eradicated and the patients had remained free of recurrence in the first years of follow-up.

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