Nov. 3 (UPI) — A person’s risk of stomach bleeding from long-term aspirin use can be reduced by taking a short course of antibiotics, which could potentially improve the safety of aspirin taken to prevent heart attacks or strokes, results of a clinical trial suggest.
Aspirin use is widespread and increasing among elderly patients, the researchers said. The main worry is gastrointestinal bleeding, whose prevalence may be increasing because of rising aspirin use.
This problem occurs because aspirin, by thinning the blood, makes ulcers in the stomach bleed. And these stomach ulcers, also known as peptic ulcers, may be caused by a particular type of bacteria: helicobacter pylori, or H. pylori.
The major clinical trial, which was conducted in the United Kingdom, was based on evidence that peptic ulcer bleeding in aspirin users occurs predominantly in H. pylori-positive people.
Risks for people already on aspirin are low, but become higher when people first begin long-term aspirin therapy — and that is the time when searching for H. pylori and treating it seems optimal, the researchers said in a news release.
So, investigators looked into whether a short course of antibiotics to remove these bacteria would reduce the risk of stomach bleeding in aspirin users.
The results from the Helicobacter pylori Eradication Aspirin Trial, known as HEAT, which studied H pylori-infected individuals taking aspirin daily in England, Wales and Northern Ireland, were published Thursday in The Lancet.
“Aspirin has many benefits in terms of reducing the risk of heart attacks and strokes in people at increased risk. There is also evidence that it is able to slow down certain cancers,” Christopher Hawkey, a professor of gastroenterology who led the study, said in the release.
“The HEAT trial is the largest U.K.-based study of its kind, and we are pleased that the findings have shown that ulcer bleeding can be significantly reduced following a one-week course of antibiotics.’
Hawkey, from the University of Nottingham’s School of Medicine and Nottingham Digestive Diseases Center in the United Kingdom, described the long-term implications of the study’s findings as “encouraging in terms of safe prescribing.”
The randomized, double-blind, placebo-controlled trial was conducted in 1,208 general medical practices in the United Kingdom, the release said.
Patients were identified by their physicians, and then asked to participate in the study and take an H. pylori breath test.
Those with a positive result were randomized to receive either a short course of antibiotic treatment or placebo. No follow-up visits were required. Instead, information was gathered from the patients’ electronic medical records.
According to clinicaltrials.gov, active treatment for the study consisted of seven days of three oral medications: lansoprazole, 30 milligrams twice daily; clarithromycin, 500 mg. twice daily; and metronidazole, 400 mg. twice daily.
Over the first 2 1/2 years, people who received the antibiotic treatment were less likely to be admitted to the hospital because of peptic ulcer bleeding than those who received placebo tablets, the study found.
The scientists discovered that protection occurred rapidly. The first hospitalization for peptic ulcer bleeding in people who got placebo tablets occurred after six days, versus 525 days after antibiotic treatment, the release said.
Over a longer period, the protection seemed to wane, the researchers noted.
