Eradication of Helicobacter pylori may reduce disease severity in rheumatoid arthritis

被引:78
作者
Zentilin, P
Seriolo, B
Dulbecco, P
Caratto, E
Iiritano, E
Fasciolo, D
Bilardi, C
Mansi, C
Testa, E
Savarino, V
机构
[1] Univ Genoa, DIMISM, Cattedra Gastroenterol, I-16132 Genoa, Italy
[2] Univ Genoa, Cattedra Reumatol, I-16132 Genoa, Italy
关键词
D O I
10.1046/j.1365-2036.2002.01284.x
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background: A triggering infectious agent has long been postulated in rheumatoid arthritis. Data on the possible role of Helicobacter pylori infection are lacking. Aims: To assess the effect of H. pylori eradication in patients with rheumatoid arthritis. Methods: Fifty-eight adult patients with established rheumatoid arthritis and dyspeptic symptoms were recruited - 28 were H. pylori -positive and 30 were H. pylori-negative on the basis of invasive tests. All infected patients were treated successfully. We evaluated the disease activity using clinical and laboratory parameters at baseline and every 4 months during 2 years, and compared the variations in the two subgroups. Results: H. pylori -eradicated rheumatoid arthritis patients showed progressive improvement over time (P < 0.0001) of all clinical indices compared with baseline, whereas H. pylori-negative rheumatoid arthritis patients remained substantially unchanged. After 2 years, H. pylori -eradicated rheumatoid arthritis patients differed significantly (P < 0.04-0.0001) from patients without H. pylori infection in terms of improvement of all clinical parameters. At the same time point, several laboratory indices (erythrocyte sedimentation rate, fibrinogen, alpha(2) -globulins and antinuclear antibody) showed significantly lower values (P < 0.02-0.0003) in the H. pylori-eradicated subgroup compared to the H. pylori -negative subgroup. Conclusions: Our data suggest that H. pylori infection is implicated in the pathogenesis of rheumatoid arthritis, in that its eradication may induce a significant improvement of disease activity over 24 months. H. pylori eradication seems to be advantageous in infected rheumatoid arthritis patients, but controlled studies are needed.
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页码:1291 / 1299
页数:9
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