Source: Pancreas  |  Posted 8 years ago

Resolution of chronic urticaria in patients infected with []Helicobacter pylori[] is more likely to occur after eradication of []H. pylori[] infection than when eradication is not achieved.

Chronic urticaria is a common clinical disorder for which a variety of potential causes have been implicated. Recently, attention has turned to []H. pylori[] as having a potential role in the pathogenesis of chronic urticaria.

Previous studies of []H. pylori[] that targeted antibiotic therapy for the treatment of chronic urticaria reported conflicting results. To further evaluate treatment of []H. pylori[] in individuals with chronic idiopathic urticaria, Daniel G. Federman, MD, Yale University School of Medicine, New Haven, Connecticut, United States, and colleagues conducted a systematic literature review of MEDLINE and Cochrane Libraries.

Ten studies met selection criteria, and included patients with urticaria persisting 6 weeks or more, excluded other known causes of urticaria, an initial diagnosis of []H. pylori[] infection by serology, urea breath test findings, or upper endoscopy, and trial completion of an antibiotic regimen with known activity against []H. pylori[]. Patients ranged in age from 10 to 82 years.

Results of this review show that a 30.9% summary rate of urticaria remission when []H. pylori[] was eradicated was, compared to 21.7% when []H. pylori[] infection persisted. Among []H. pylori[] negative controls, the background urticaria remission rate was 13.5%.

When data across studies was combined, []H. pylori[] eradication was associated with urticaria remission, with an odds ratio of 2.9 (95% confidence interval [CI] 1.4-6.8; []P[] = .005). Similar results were observed when patients treated with placebo were excluded from analysis.

Comparing patients whose []H. pylori[] was eradicated and H. pylori negative controls, the odds ratio for urticaria remission was 4.7 (95% CI 2.6-17.6, []P[] < .001).

The results of this review suggest that after considering other causes of chronic urticaria, clinicians should test these patients for []H. pylori[] infection, provide positive patients with antibiotic treatment, and confirm infection eradication, the researchers conclude.