Effect of Helicobacter pylori Eradication on Disease Symptoms, Inflammation, and Quality of Life in Patients with Rheumatoid Arthritis: A Non-blinded Prospective Quasi-experimental Study

INTRODUCTION: We investigated the effects of Helicobacter pylori (H. pylori) eradication on quality of life (QoL), pain, inflammation, and other symptoms in rheumatoid arthritis (RA) patients. METHODS: In this study, patients with RA were divided into H.pylori-positive and H. pylorinegative groups. The positive group received a 5-day eradication treatment plus standard RA treatment. The negative group received only standard RA treatment. Arthritis severity, Disease Activity Score 28 (DAS28), VAS, the European Quality of Life Questionnaire (EQ-5D), Creactive protein (CRP), and erythrocyte sedimentation rate (ESR) were evaluated before treatment, at 4 and 8 weeks post-treatment. RESULTS: The H. pylori-positive group had significantly lower arthritis severity, painful joints, morning stiffness, disease activity, CRP, and ESR (p <0.05). The Health Assessment Questionnaire (HAQ) score at week 8 and pain at weeks 4 and 8 were significantly less than those of the H. pylori-positive (p <0.05). Only the HAQ score differed significantly between the groups, with greater improvement in the H. pylori-positive group. Moreover, the last component of the QoL improved significantly (all p <0.05). DISCUSSION: H. pylori eradication may confer additional benefits in RA, as greater improvements in inflammation, pain, functional status, and QoL were observed in the H. pylori-positive group. These results support a potential role of chronic infection in RA disease activity. More clinical trials with larger samples and longer follow-up are needed. CONCLUSION: Disease activity, pain, HAQ scores, and QoL improved for all patients, indicating the regimen's effectiveness. More pronounced improvements in the H. pylori-positive patients suggest a possible association between eradication therapy and symptom improvement.