Efficacy of Helicobacter pylori eradication for the 1st line treatment of immune thrombocytopenia patients with moderate thrombocytopenia

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• 作者：Hawk Kim ; Won-Sik Lee ; Kyoo-Hyung Lee ; Sung Hwa Bae ; Min Kyoung Kim…
• 关键词：Helicobacter pylori ; Immune thrombocytopenia ; Eradication
• 刊名：Annals of Hematology
• 出版年：2015
• 出版时间：May 2015
• 年：2015
• 卷：94
• 期：5
• 页码：739-746
• 全文大小：574 KB
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• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Hematology
  Oncology
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1432-0584

文摘

The practical usefulness of Helicobacter pylori eradication for immune thrombocytopenia (ITP) patients is still controversial. However, some ITP patients respond to H. pylori eradication. We conducted a multi-center, open label, prospective phase II study to define the efficacy and toxicities of H. pylori eradication as the first line treatment for persistent or chronic ITP patients with moderate thrombocytopenia. Patients with persistent or chronic ITP showing moderate thrombocytopenia (30?×-09/L?≤?platelet count?≤-0?×-09/L) and positive C13-urea breath test (UBT) were selected. Medication consisted of lansoprazole 30?mg, amoxicillin 1000?mg, and clarithromycin 500?mg orally twice daily for a week. Complete response (CR) rate at 4?weeks, 3?months, 6?months, 12?months, and maximal response was 19.2, 50.0, 50.0, 26.9, and 65.4?%, respectively. Overall response rate (ORR) at 4?weeks, 3?months, 6?months, 12?months, and maximal response was 19.2, 57.7, 65.4, 30.8, and 69.2?%, respectively. Median maximal platelet count during the first 3?months was 110?×-09/L (range, 40-74). Median time to CR was 8?weeks (95?% CI--.429-0.571). Median time to ORR was 4?weeks (95?% CI--.228-.772). Only per-protocol population was a response predictor for ORR at 3?months (70.0?%, p--.054) and maximal ORR (80.0?%, p--.051), but not for CR at 3?months (60.0?%, p--.160). Therefore, eradication of H. pylori is an effective and durable first line treatment for persistent or chronic ITP with moderate thrombocytopenia with high ORR and rapid onset in this study.