PREVALENCE OF HELICOBACTER-PYLORI IN ACROMEGALIC PATIENTS DURING TREATMENT WITH OCTREOTIDE

BACKGROUND Octreotide, a synthetic long-acting analogue of somatostati n, now has an established role in the treatment of acromegaly. In acro megalic patients treated with octreotide there is an increased inciden ce of gallstones and possibly gastritis. OBJECTIVES (1) To compare the seroprevalence of Helicobacter pylori (H. pylori) infection, in acrom egalic patients treated with octreotide to that in patients given othe r treatment modalities. (2) To study retrospectively the temporal rela tion between H. pylori acquisition and octreotide treatment. PATIENTS Three groups of acromegalic patients were studied; 35 (20 M) had been treated with octreotide, 17 (10 M) with bromocriptine and 19 (12 M) ha d received no pharmacological intervention (untreated, surgically trea ted or treated with radiotherapy). DESIGN/MEASUREMENTS The presence of H. pylori infection was assessed serologically (Bio-Rad GAP test for IgG), using stored serum, on the most recent sample from each patient and on serial samples from patients treated with octreotide. RESULTS T he prevalence of H. pylori seropositivity was similar in each treatmen t group, 34, 35 and 37%, respectively. Mean age and duration of acrome galy were similar in the first two groups. Patients who had never rece ived medical treatment were slightly younger. GH levels were similar i n all three groups. Patients on octreotide who were seropositive for H . pylori did not differ from those with negative serology with respect to age, duration of acromegaly, duration of octreotide treatment or s erum GH level. Serial samples in octreotide treated patients showed a change in status in only one patient; 18 patients dcontinued with nega tive serology during a mean period of 30 (range 4-62) months, In each of the 6 patients with persistently positive serology during octreotid e treatment, stored samples predating octreotide therapy were shown to have already been positive. CONCLUSIONS The seroprevalence of H. pylo ri infection in acromegalic patients does not appear to be increased i n a manner dependent on the type or duration of medical treatment. In particular, octreotide therapy, while causing the development of histo logical gastritis in some patients, does not appear to induce the deve lopment of H. pylori infection.