Samuel J. Martínez-Domínguez, Olga P. Nyssen, Ángel Lanas, Enrique Alfaro, Laimas Jonaitis, Umud Mahmudov, Irina Voynovan, Babayeva Gülüstan, Luis Rodrigo, Giulia Fiorini, Ángeles Perez-Aisa, Javier Tejedor-Tejada, Bojan Tepes, Ludmila Vologzanina, Emin Mammadov, Frode Lerang, Quliyev Fərid Vidadi Oğlu, Natalia V. Bakulina, Rustam Abdulkhakov, Ilchishina Tatiana, Thomas J. Butler, Aiman Silkanovna Sarsenbaeva, Renate Bumane, Alfredo J. Lucendo, Marco Romano, Luis Bujanda, Sayar R. Abdulkhakov, Oleg Zaytsev, Manuel Pabón-Carrasco, Alma Keco-Huerga, Maja Denkovski, Jose M. Huguet, Monica Perona, Óscar Núñez, Matteo Pavoni, Galyna Fadieienko, Sergey Alekseenko, Sinead M. Smith, Luis Hernández, Juozas Kupcinskas, Dmitry S. Bordin, Mārcis Leja, Antonio Gasbarrini, Oleksiy Gridnyev, Anna Cano-Català, Pablo Parra, Leticia Moreira, Francis Mégraud, Colm O'Morain, Javier P. Gisbert, the Hp-EuReg Investigators
{"title":"Indications of Helicobacter pylori Eradication Treatment and Its Influence on Prescriptions and Effectiveness (Hp-EuReg)","authors":"Samuel J. Martínez-Domínguez, Olga P. Nyssen, Ángel Lanas, Enrique Alfaro, Laimas Jonaitis, Umud Mahmudov, Irina Voynovan, Babayeva Gülüstan, Luis Rodrigo, Giulia Fiorini, Ángeles Perez-Aisa, Javier Tejedor-Tejada, Bojan Tepes, Ludmila Vologzanina, Emin Mammadov, Frode Lerang, Quliyev Fərid Vidadi Oğlu, Natalia V. Bakulina, Rustam Abdulkhakov, Ilchishina Tatiana, Thomas J. Butler, Aiman Silkanovna Sarsenbaeva, Renate Bumane, Alfredo J. Lucendo, Marco Romano, Luis Bujanda, Sayar R. Abdulkhakov, Oleg Zaytsev, Manuel Pabón-Carrasco, Alma Keco-Huerga, Maja Denkovski, Jose M. Huguet, Monica Perona, Óscar Núñez, Matteo Pavoni, Galyna Fadieienko, Sergey Alekseenko, Sinead M. Smith, Luis Hernández, Juozas Kupcinskas, Dmitry S. Bordin, Mārcis Leja, Antonio Gasbarrini, Oleksiy Gridnyev, Anna Cano-Català, Pablo Parra, Leticia Moreira, Francis Mégraud, Colm O'Morain, Javier P. Gisbert, the Hp-EuReg Investigators","doi":"10.1111/hel.13111","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>The influence of indications for <i>Helicobacter pylori</i> investigation on prescriptions and effectiveness is unknown. The aim of the study was to assess the impact of indications for <i>H. pylori</i> investigation on prescriptions, effectiveness, compliance, and tolerance.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>International, prospective, non-interventional registry of the management of <i>H. pylori</i> infection by European gastroenterologists (Hp-EuReg). Treatment-näive patients registered from 2013 to 2023 at e-CRF AEG-REDCap were analyzed. The effectiveness was assessed by modified intention-to-treat analysis.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Overall, 53,636 treatment-naïve cases from 34 countries were included. Most frequent indications were: dyspepsia with normal endoscopy (49%), non-investigated dyspepsia (20%), duodenal ulcer (11%), gastric ulcer (7.7%), and gastroesophageal reflux disease (GERD) (2.6%). Therapy effectiveness varied by indication: duodenal ulcer (91%), gastric ulcer (90%), preneoplastic lesions (90%), dyspepsia with normal endoscopy (89%), GERD (88%), and non-investigated dyspepsia (87%). Bismuth-metronidazole-tetracycline and clarithromycin-amoxicillin-bismuth quadruple therapies achieved 90% effectiveness in all indications except GERD. Concomitant clarithromycin-amoxicillin-tinidazole/metronidazole reached 90% cure rates except in patients with non-investigated dyspepsia; whereas sequential clarithromycin-amoxicillin-tinidazole/metronidazole proved optimal (≥90%) in patients with gastric ulcer only. Adverse events were higher in patients treated for dyspepsia with normal endoscopy and duodenal ulcer compared with the remaining indications (23% and 28%, <i>p</i> < 0.001). Therapeutic compliance was higher in patients with duodenal ulcer and preneoplastic lesions (98% and 99%, <i>p</i> < 0.001).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>In Europe, patients with gastric or duodenal ulcers and preneoplastic lesions showed higher <i>H. pylori</i> treatment effectiveness. Bismuth and non-bismuth quadruple therapies achieved optimal results in almost all indications.</p>\n </section>\n \n <section>\n \n <h3> Trial Registration</h3>\n \n <p>ClinicalTrials.gov identifier: NCT02328131.</p>\n </section>\n </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 4","pages":""},"PeriodicalIF":4.3000,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.13111","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Helicobacter","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/hel.13111","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background
The influence of indications for Helicobacter pylori investigation on prescriptions and effectiveness is unknown. The aim of the study was to assess the impact of indications for H. pylori investigation on prescriptions, effectiveness, compliance, and tolerance.
Methods
International, prospective, non-interventional registry of the management of H. pylori infection by European gastroenterologists (Hp-EuReg). Treatment-näive patients registered from 2013 to 2023 at e-CRF AEG-REDCap were analyzed. The effectiveness was assessed by modified intention-to-treat analysis.
Results
Overall, 53,636 treatment-naïve cases from 34 countries were included. Most frequent indications were: dyspepsia with normal endoscopy (49%), non-investigated dyspepsia (20%), duodenal ulcer (11%), gastric ulcer (7.7%), and gastroesophageal reflux disease (GERD) (2.6%). Therapy effectiveness varied by indication: duodenal ulcer (91%), gastric ulcer (90%), preneoplastic lesions (90%), dyspepsia with normal endoscopy (89%), GERD (88%), and non-investigated dyspepsia (87%). Bismuth-metronidazole-tetracycline and clarithromycin-amoxicillin-bismuth quadruple therapies achieved 90% effectiveness in all indications except GERD. Concomitant clarithromycin-amoxicillin-tinidazole/metronidazole reached 90% cure rates except in patients with non-investigated dyspepsia; whereas sequential clarithromycin-amoxicillin-tinidazole/metronidazole proved optimal (≥90%) in patients with gastric ulcer only. Adverse events were higher in patients treated for dyspepsia with normal endoscopy and duodenal ulcer compared with the remaining indications (23% and 28%, p < 0.001). Therapeutic compliance was higher in patients with duodenal ulcer and preneoplastic lesions (98% and 99%, p < 0.001).
Conclusion
In Europe, patients with gastric or duodenal ulcers and preneoplastic lesions showed higher H. pylori treatment effectiveness. Bismuth and non-bismuth quadruple therapies achieved optimal results in almost all indications.
期刊介绍：
Helicobacter is edited by Professor David Y Graham. The editorial and peer review process is an independent process. Whenever there is a conflict of interest, the editor and editorial board will declare their interests and affiliations. Helicobacter recognises the critical role that has been established for Helicobacter pylori in peptic ulcer, gastric adenocarcinoma, and primary gastric lymphoma. As new helicobacter species are now regularly being discovered, Helicobacter covers the entire range of helicobacter research, increasing communication among the fields of gastroenterology; microbiology; vaccine development; laboratory animal science.
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