幽门螺杆菌根除治疗无法改善帕金森病症状
创作:szx 审核:szx 2020年10月22日
  • 67名HP阳性的帕金森病患者随机分为2组,32名接受HP根除治疗,35名接受安慰剂治疗,持续1周;
  • 在第6、12、24、52周进行随访,评估运动功能、非运动功能及生活质量;
  • HP根除治疗未能显著改善12周后的患者MDS-UPDRS运动评分(主要终点);
  • 第12周及第52周,HP根除治疗均未显著改善任意的运动功能、非运动功能及生活质量评分;
  • 小肠细菌过度生长的状态对治疗结果无影响。
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szx
Movement Disorders上发表的一项随机对照试验结果,对67名幽门螺杆菌(HP)阳性的帕金森病患者进行HP根除治疗或安慰剂治疗,在随访12周及52周后,HP根除治疗并未显著改善患者的任何临床结局(包括运动功能、非运动功能及生活质量)。
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Movement Disorders [IF:8.679]

Helicobacter pylori Eradication in Parkinson's Disease: A Randomized Placebo‐Controlled Trial

对帕金森病患者进行幽门螺杆菌根除治疗:一项随机安慰剂对照试验

10.1002/mds.28248

2020-09-07, Article

Abstract & Authors:展开

Abstract:收起
Background: Helicobacter pylori (HP) infection has been associated with worse motor function in Parkinson's disease (PD).
Objective: We aimed to evaluate the effects of HP eradication on PD symptoms.
Methods: In this parallel‐group, double‐blind, randomized placebo‐controlled, single‐center trial, patients with PD with positive HP urea breath test and serology were block randomized (1:1) to receive standard eradication triple therapy or identically appearing placebo capsules for 1 week. Prespecified motor (International Parkinson and Movement Disorder Society Unified PD Rating Scale [MDS‐UPDRS], timed tests, and home‐based wearable sensor measurements), nonmotor (Leeds Dyspepsia Questionnaire and Montreal Cognitive Assessment), and quality‐of‐life (Parkinson's Disease Questionnaire‐39) outcome measures were assessed at weeks 6, 12, 24, and 52. The primary outcome was the baseline‐to‐week 12 change in ON medication MDS‐UPDRS motor scores. Lactulose‐hydrogen breath testing for concomitant small intestinal bacterial overgrowth was performed at baseline and repeated at week 24, together with the urea breath test.
Results: A total of 310 patients were screened for eligibility and 80 were randomly assigned, of whom 67 were included in the full‐analysis set (32 treatment group patients, 35 placebo patients). HP eradication did not improve MDS‐UPDRS motor scores at week 12 (mean difference 2.6 points in favor of placebo, 95% confidence interval: −0.4 to 5.6, P = 0.089). There was no significant improvement in any motor, nonmotor, or quality‐of‐life outcome at weeks 12 and 52. Both the full‐analysis and per‐protocol analyses (based on eradication status) supported these conclusions. Small intestinal bacterial overgrowth status did not influence treatment results.
Conclusions: HP eradication does not improve clinical outcomes in PD, suggesting that there is no justification for routine HP screening or eradication with the goal of improving PD symptoms. © 2020 International Parkinson and Movement Disorder Society

First Authors:
Ai Huey Tan

Correspondence Authors:
Ai Huey Tan

All Authors:
Ai Huey Tan,Shen‐Yang Lim,Sanjiv Mahadeva,Mun Fai Loke,Jiun Yan Tan,Ban Hong Ang,Kok Ping Chin,Amni Fatihah Mohammad Adnan,Shawna Mei Chien Ong,Aimi Izzah Ibrahim,Nusyaibah Zulkifli,Jing Kun Lee,Wan Ting Lim,Yong Teck Teo,Yong Leng Kok,Tze Ying Ng,Aaron Guan Siang Tan,Intan Maisara Zulkifle,Chin Khoon Ng,Soon Sean Ee,Shuhaina Arafin,Khairunnisa Mohamad Shukori,Jamunarani S Vadivelu,Connie Marras,Susan H Fox,Anthony E Lang

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