Sverden E, et al. - This population-based cohort study was conducted to examine how various lengths of delays in Helicobacter pylori (H pylori) eradication therapy could influence the risk of recurrent peptic ulcer, ulcer adverse events, and gastric cancer. Delay in H pylori eradication therapy following peptic ulcer diagnosis time-dependently increased the risk of recurrent ulcer, and even more so for a complicated ulcer, starting from delays of 8 to 30 days.

Methods

• The researchers enrolled 29,032 patients receiving H pylori eradication therapy after peptic ulcer disease in 2005-2013.
• They examined pre-defined time intervals between date of peptic ulcer diagnosis and date of eradication therapy, in relation to study outcomes.
• Hazard ratios (HRs) and 95% confidence intervals (95% CIs), adjusted for age, sex, comorbidity, history of ulcer disease, use of ulcerogenic drugs, and use of proton pump inhibitors (PPIs) were provided by Cox regression.

Results

• Eradication therapy within 8 to 30, 31 to 60, 61 to 365, and >365 days corresponded with HRs of recurrent ulcer of 1·17 (95% CI, 1·08-1·25), 2·37 (95%,CI, 2·16-2·59), 2·96 (95%,CI, 2·76-3·16), and 3·55 (95% CI, 3·33-3·79), respectively, compared to eradication therapy within 7 days of peptic ulcer diagnosis.
• For complicated ulcer, the corresponding HRs were 1·55 (95% CI, 1·35-1·78), 3·19 (95% CI, 2·69-3·78), 4·00 (95% CI, 3·51-4·55), and 6·14, 95% CI, 5·47-6·89), respectively.
• The corresponding HRs for gastric cancer were 0·85 (95% CI, 0·32-2·23), 1·31 (95% CI, 0·31-5·54), 3·64 (95% CI, 1·55-8·56), and 4·71 (95% CI, 2·36-9·38), respectively.