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Dermatology Other
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my personal edition > dermatology other > news
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DGReview
Chronic Urticaria Remission More Likely After Helicobacter Pylori Eradication
A DGReview of :"The effect of antibiotic therapy for patients infected with Helicobacter pylori who have chronic urticaria"
Journal of the American Academy of Dermatology
11/28/2003
By Jill Taylor
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.
J Am Acad Dermatol 2003 Nov;49:5:861-4.
"The effect of antibiotic therapy for patients infected with Helicobacter pylori who have chronic urticaria"
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