Helicobacter pylori eradication therapy and clinical outcomes in Parkinson's disease: a double-blind randomized placebo-controlled trial
In brief
Helicobacter pylori eradication fails to improve Parkinson motor or non-motor scores
In a double-blind trial of 30 HP-positive Parkinson patients, a two-week triple-antibiotic regimen did not change the MDS-UPDRS motor score, total UPDRS, non-motor symptom burden, or quality-of-life measures after 12 weeks compared with placebo. The result suggests routine HP eradication should not be added to standard Parkinson therapy, though longer follow-up was not assessed.
- Journal
- Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology (Q1)
- Published
- 11 August 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Gopal Vishwas, Ashish Kumar Kakkar, Sahil Mehta, Smita Pattanaik, Shalmoli Bhattacharyya, Vishal Sharma, et al.
- PMID
- 42579018
- DOI
- 10.1007/s10072-026-09307-7
Why clinicians should know about it
- Picked for Microbiology (medical) (top studies of the week, 16 August 2026): H. pylori eradication in Parkinson’s, clinical trial not diagnostics
Abstract
BACKGROUND: Helicobacter pylori (HP) infection has been implicated in modifying treatment response and clinical outcomes in Parkinson's disease(PD). This study aimed to evaluate the effect of HP eradication therapy on motor symptoms, non-motor symptom burden, and quality of life in patients with PD. METHODS: We conducted a double-blind, randomised, placebo-controlled trial in which HP-positive adults with PD were randomised (1:1) to standard triple eradication therapy (omeprazole 20 mg, amoxicillin 1000 mg, and clarithromycin 500 mg, each twice-daily for 14 days) or matched placebo. The primary outcome was the MDS-Unified Parkinson's Disease Rating Scale(MDS-UPDRS) Part III motor score in the ON medication state at 12 weeks. Secondary outcomes included total MDS-UPDRS score, Non-Motor Symptoms Scale (NMSS) score, and Parkinson's Disease Questionnaire-39 (PDQ-39) summary index score. RESULTS: Out of eighty participants who underwent urea-breath testing, 34 tested positive. Of them, 30 participants were randomised to the two treatment groups. The primary outcome did not differ significantly between groups at 12 weeks (mean difference -3.9; 95% CI -15.5 to 7.6; p=0.49), which was unchanged after adjustment for baseline scores (p=0.13). No significant between-group differences were observed in total MDS-UPDRS score(mean difference -0.13; 95% CI -22.1 to 21.8; p=0.99), NMSS score(mean difference 23.3; 95% CI-8.8 to 55.4; p=0.15), or PDQ-39 scores(mean difference -7.1; 95% CI -35.4 to 21.1; p=0.61). CONCLUSIONS: HP eradication therapy did not improve motor symptoms, non-motor symptom burden, or quality of life in PD patients over 12 weeks. These findings do not support routine HP eradication as an adjunctive strategy for improving PD symptom control. TRIAL REGISTRATION: CTRI/2019/04/018524.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.