Role of Helicobacter pylori Eradication in Chronic Spontaneous Urticaria: A Propensity Score Matching Analysis

OBJECTIVE: To investigate the role of Helicobacter pylori (HP) eradication in chronic spontaneous urticaria (CSU) treatment. METHODS: Retrospective analysis was performed on the clinical data of 522 patients with CSU who underwent a HP breath test in Hangzhou Third People’s Hospital between January 2018 and December 2019. The CSU-HP(+) group consisted of patients with CSU and HP infection, who were treated with antihistamines combined with HP eradication therapy. The CSU-HP(-) group consisted of patients with CSU alone, who were treated with antihistamines. Propensity score matching (PSM) analysis, using the nearest neighbor matching method on a 1:1 basis, was performed to ensure the characteristics of the CSU-HP(+) and CSU-HP(-) groups were similar. Factors, including age, gender, white blood cells, red blood cells, platelets, alanine transaminase, creatinine, immunoglobulin E, and pre-treatment urticaria activity score (UAS), were matched to obtain a balanced cohort of patients in each group. Therapeutic effects were compared after matching. t-tests, Χ(2) test, and McNemar’s test were used for comparison between the two groups before and after matching. RESULTS: Patients in the CSU-HP(+) group reported significantly more gastrointestinal symptoms than those in the CSU-HP(-) group. UAS scores in the second week of treatment were significantly different between the two groups. After 3 months, the recurrence rate in the CSU-HP(+) group was lower than in the CSU-HP(-) group. CONCLUSION: Eradication of HP infection in patients with CSU helps relieve gastrointestinal symptoms, improves the therapeutic effect of CSU within 2 weeks, and reduces the recurrence rate 3 months after treatment.