Reply
N. Ishikawa and
T. Matsumoto
Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Maidashi 311, Higashi-ku, Fukuoka, Japan
Thank you for valuable comments by Drs Kelly and Saravanan to our article published in an issue of Rheumatology [1]. We also apologize for the insufficient information in the article.
In accordance with the recommendation, we analysed the correlation between H. pylori status and endoscopic findings in symptomatic RA patients (Table 1
). Even in dyspeptic patients, there were no significant differences in the incidence of gastric and duodenal ulcers between H. pylori-positive and -negative patients. However, there was a trend towards a higher incidence of duodenal ulcer in H. pylori-positive patients than in H. pylori-negative patients (10.8 vs 4.3%).
There seem to be several explanations for the discrepancies between our results and those of Drs Kelly and Saravanan [2]. First, we may have analysed fewer symptomatic patients than in the investigation by Drs Kelly and Saravanan. In the second place, differences in the types of NSAID may be responsible. In fact, in the study of Drs Kelly and Saravanan, only 60% of the subjects were taking NSAIDs. Differences in the background of RA may have contributed to the differences in the results. So far, our results do not justify endoscopy for dyspeptic RA patients who are taking long-term NSAIDs.
Notes
Correspondence to: N. Ishikawa. E-mail: nkishi{at}syd.odn.ne.jp 
References
- Ishikawa N, Fuchigami T, Matsumoto T et al. Helicobacter pylori infection in rheumatoid arthritis: effect of drugs on prevalence and correlation with gastroduodenal lesions. Rheumatology 2002;41:727.[Abstract/Free Full Text]
- Grigoriadou S, Quraishi A, Saravanna S, Saravanan V, Heycock C, Kelly C. What effect does Helicobacter pylori infection have on the risk of peptic ulceration in patients receiving NSAIDs for rheumatoid arthritis? Eur J Intern Med 2002;13:26973.[CrossRef][Medline]
Accepted 1 July 2002