Francis K.L. Chan, MD, of the Chinese University of Hong Kong, and colleagues conducted a prospective study to compare the incidence of recurrent ulcer bleeding in three different cohorts of patients: ASA users with a history of ulcer and eradication of H. pylori, ASA users with a history of ulcer and negative for H. pylori, and new ASA users with no history of ulcer and unknown H. pylori status.
According to the researchers, the incidence rate of ulcer bleeding in the H. pylori-eradicated cohort was similar to that found in the new ASA users cohort (0.97 per 100 patient-years [95 percent confidence interval, 0.53 to 1.80] and 0.66, respectively). In contrast, the H. pylori-negative cohort had the highest incidence of recurrent bleeding (5.22). The incidence of ulcer bleeding was five times higher than that found in the H. pylori-eradicated cohort and eight times higher than that found in the new ASA users cohort.
"ASA users who developed ulcer bleeding without current or past H. pylori infection are at high risk of recurrent bleeding," the authors write. "Our study provides novel data to guideline committees to refine their treatment recommendations for ASA users who are at risk of ulcer bleeding."
Several authors disclosed financial ties to the pharmaceutical industry.