Objective: This study aimed to determine the effects of Helicobacter Pylori(HP) eradication treatment on motor and non-motor symptoms and quality of life of PD patients

Background: Observational studies examining HP eradication in Parkinson’s disease suggest that infection negatively impacts levodopa absorption, motor fluctuations, and clinical response, with eradication leading to varying degrees of improvement. Previous studies consistently report that HP infection delays levodopa onset time and reduces ‘on-time,’ both of which improve following eradication. However, due to the scarcity of robust evidence from RCTs employing validated outcome measures, there are currently no formal evidence-based recommendations supporting HP eradication as a potential therapeutic strategy in Parkinson’s disease. Data are especially sparse from low- and middle-income settings, resulting in a significant gap in knowledge

Method: This was a parallel group, double blind, randomized placebo-controlled trial. Eligible PD participants who consented for participation and were HP positive based on urea breath testing were randomly assigned(1:1 ) to receive either standard HP eradication triple therapy or identical placebo for 2 weeks using a computer-generated randomization sequence. Primary outcome was ON medication MDS Parkinson’s Disease Rating Scale[MDS-UPDRS] at 12 weeks after randomization. We also assessed non-motor symptom scale(NMSS) score and Parkinson’s Disease Questionnaire-39(PDQ-39) score at 12 weeks as key secondary outcomes

Results: A total of 30 HP positive participants underwent randomization and were allocated to treatment group(n=15) and placebo group n=15) respectively. All patients completed their participation in the study and were included in the final analysis data set. HP eradication treatment did not improve MDS-UPDRS motor scores at 12 weeks[mean difference:-3.9, p=0.49]. the difference remained non-significant even after adjustment for baseline motor scores. No significant improvement was noted for non-motor symptom score as well as quality of life scores

Conclusion: HP eradication did not improve motor scores or other secondary outcomes. This study failed to replicate the benefits observed in earlier studies, suggesting that HP eradication may not translate into meaningful clinical improvement in PD.

*AK and GV contributed equally to this work

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MDS Abstracts - https://www.mdsabstracts.org/abstract/evaluation-of-impact-of-helicobacter-pylori-eradication-on-symptomatology-and-quality-of-life-in-parkinsons-disease/