Efficacy and safety of Helicobacter pylori eradication therapy immediately after endoscopic submucosal dissection.

Background and AimsIn the treatment of patients after endoscopic submucosal dissection (ESD), there is no consensus on the optimum time to start Helicobacter pylori eradication therapy or on whether eradication therapy improves ulcer healing rate after ESD. The aim of this study was to examine the effect of immediate eradication of H.pylori on ulcer healing after ESD in patients with early gastric neoplasms. MethodsA total of 330 patients who underwent ESD for early gastric neoplasms were enrolled. Patients were assigned to either H.pylori eradication group (Group A: H.pylori eradication+proton pump inhibitor 7weeks) or non-eradication group (Group B: proton pump inhibitor 8weeks). The primary end point was gastric ulcer healing rate (Group A vs Group B) determined on week 8 after ESD. ResultsPatients in Group A failed to meet non-inferiority criteria for ulcer scarring rate after ESD compared with that in Group B (83.0% vs 86.5%, P for non-inferiority=0.0599, 95% confidence interval: -11.7% to 4.7%). There were, however, neither large differences between the two groups in the ulcer scarring rate nor the safety profile. ConclusionsThis study failed to demonstrate the non-inferiority of immediate H.pylori eradication therapy after ESD to the non-eradication therapy in the healing rate of ESD-caused ulcers. However, because the failure is likely to attribute to small number of patients enrolled, immediate eradication therapy may be a treatment option for patients after ESD without adverse effects on eradication therapy in comparison with the standard therapy.