After peptic ulcer diagnosis, waiting >1 week to begin Helicobacter pylori eradication therapy may raise risk for recurrent and complicated ulcer and gastric cancer.
Why this matters
Delays in H pylori eradication are common, but consequences are unclear.
- 7629 patients developed recurrent ulcer, 2050 complicated ulcer, and 50 gastric cancer.
- Recurrent ulcer risks with treatment delays vs within 7 days:
- 8-30 days: HR, 1.17;
- >365 days: HR, 3.55.
- Complicated ulcer risks with treatment delays vs within 7 days:
- 8-30 days: HR, 1.55;
- >365 days: HR, 6.14.
- Gastric cancer risk with treatment delays vs within 7 days:
- 61-365 days: HR, 3.64;
- >365 days: HR, 4.71.
- For all trends: P<.001.>
- Researchers calculated that 23% of recurrent ulcers, 33% of complicated ulcers, and 30% of gastric cancers could be prevented with H pylori treatment within 1 month of ulcer diagnosis.
- Population-based nationwide Swedish cohort study, adults treated for H pylori after peptic ulcer diagnosis (n=29,032).
- Using registry data, researchers compared outcomes to time elapsed between ulcer diagnosis and H pylori treatment.
- Follow-up: 75 months.
- Outcomes: recurrent ulcer, complicated ulcer, gastric cancer.
- Funding: Swedish nonprofit organizations; Karolinska Institutet.
- Data on smoking, alcohol consumption not available.
- Causality not established.