PMID- 12943489
OWN - NLM
STAT- MEDLINE
DCOM- 20031014
LR  - 20190916
IS  - 1465-6566 (Print)
IS  - 1465-6566 (Linking)
VI  - 4
IP  - 9
DP  - 2003 Sep
TI  - Recurrent duodenal ulcer haemorrhage: a pharmacoeconomic comparison of various 
      management strategies.
PG  - 1593-603
AB  - BACKGROUND: Duodenal ulcer (DU) bleeding has a 7 - 13% mortality rate and 
      bleeding often recurs. Prevention of recurrence is, therefore, an important goal. 
      Eradication of Helicobacter pylori or maintenance treatment with a proton pump 
      inhibitor (PPI) may reduce recurrent DU bleeding. Economic comparison of these 
      options is sparse. METHODS: After the control of index bleeding with endotherapy 
      and drugs, three strategies were evaluated: empirical treatment for possible H. 
      pylori infection followed by a PPI for 2 months; test for H. pylori, eradication 
      if positive, maintenance PPI if negative; maintenance PPI alone. Probability and 
      direct cost data were obtained from a Medline search and Indian hospitals, 
      respectively. Cost-minimisation, cost-utility, one- and two-way sensitivity 
      analyses and threshold values were evaluated. RESULTS: Treatment of H. pylori, 
      particularly empirical, was the preferred strategy and dominated maintenance 
      treatment with PPI. The test-and-treat strategy was better than the empirical 
      treatment strategy only when the probabilities of H. pylori eradication, ulcer 
      healing following eradication and of frequency of H. pylori infection in bleeding 
      DU were less than 58, 73 and 58%, respectively. CONCLUSIONS: Eradication of H. 
      pylori is preferred in preventing recurrent bleeding from DU.
FAU - Ghoshal, Uday Chand
AU  - Ghoshal UC
AD  - Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical 
      Sciences, Raebareli Road, Lucknow 226014, India. ghoshal@sgpgi.ac.in
FAU - Aggarwal, Rakesh
AU  - Aggarwal R
FAU - Baba, Chalamalasetty Sreenivasa
AU  - Baba CS
LA  - eng
PT  - Journal Article
PL  - England
TA  - Expert Opin Pharmacother
JT  - Expert opinion on pharmacotherapy
JID - 100897346
RN  - 0 (Proton Pump Inhibitors)
RN  - 0 (Proton Pumps)
SB  - IM
MH  - Clinical Trials as Topic
MH  - Costs and Cost Analysis
MH  - Duodenal Ulcer/complications/drug therapy/*economics
MH  - Helicobacter Infections/complications/drug therapy/economics/microbiology
MH  - Helicobacter pylori
MH  - Humans
MH  - Models, Economic
MH  - Peptic Ulcer Hemorrhage/drug therapy/*economics/etiology
MH  - Proton Pump Inhibitors
MH  - Proton Pumps/economics/therapeutic use
MH  - Quality of Life
EDAT- 2003/08/29 05:00
MHDA- 2003/10/15 05:00
CRDT- 2003/08/29 05:00
PHST- 2003/08/29 05:00 [pubmed]
PHST- 2003/10/15 05:00 [medline]
PHST- 2003/08/29 05:00 [entrez]
AID - 10.1517/14656566.4.9.1593 [doi]
PST - ppublish
SO  - Expert Opin Pharmacother. 2003 Sep;4(9):1593-603. doi: 10.1517/14656566.4.9.1593.