Helicobacter最新文献

{"title":"Response to “Re-Evaluating the Adverse Events With the Same-Dosage Regimen in Hemodialysis Patients Undergoing Helicobacter pylori Eradication”","authors":"Mitsushige Sugimoto, Shu Sahara","doi":"10.1111/hel.70080","DOIUrl":"10.1111/hel.70080","url":null,"abstract":"","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: “Gastric Cancer Endoscopic Screening in an Intermediate-Risk Country—A Dual-Center Pilot Program”","authors":"Abubakar Afzal, Zaib Un Nisa","doi":"10.1111/hel.70076","DOIUrl":"10.1111/hel.70076","url":null,"abstract":"","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Droplet Digital PCR-Based Detection of Clarithromycin Resistance on Rapid Urease Test Samples Predicts Helicobacter pylori Eradication Success: A New Zealand Cohort Study","authors":"Stephen James Inns,&nbsp;Samantha Sowerbutts,&nbsp;Bibek Yumnam,&nbsp;Kate Payne,&nbsp;Georgina Wheller,&nbsp;Mali Camberis,&nbsp;Thomas Mules","doi":"10.1111/hel.70075","DOIUrl":"https://doi.org/10.1111/hel.70075","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p><i>Helicobacter pylori</i> (<i>H. pylori</i>) infection is a major cause of peptic ulcer disease and gastric cancer. Rising clarithromycin resistance has significantly reduced the efficacy of standard triple therapy. In Aotearoa New Zealand, the prevalence and impact of antibiotic resistance remain incompletely defined, limiting the development of effective treatment strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Aims</h3>\u0000 \u0000 <p>This study evaluated the feasibility and clinical utility of detecting clarithromycin resistance genes using droplet digital polymerase chain reaction (ddPCR) on stored Rapid Urease Test (RUT) samples—a relatively novel application of molecular diagnostics. We also assessed the association between resistance status and treatment outcomes following empiric first-line triple therapy. Patients with positive RUT tests during gastroscopy were treated with omeprazole-based triple therapy and followed up with <i>H. pylori</i> stool antigen testing to confirm eradication.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 84 patients, clarithromycin resistance genes were detected in 13 (15.5%). Overall eradication was achieved in 74 (88.1%) patients. However, eradication success was significantly lower in those with resistance (38.5%) compared to those without (97.2%, <i>p</i> &lt; 0.001). Infection burden, treatment regimen, and duration were not associated with eradication rates, supporting resistance status as the primary determinant of treatment outcome. Resistance rates were similar between Māori and Pacific patients (18.2%) and other ethnic groups (14.8%), although sample sizes limited definitive conclusions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>ddPCR testing on stored RUT samples is a feasible and effective method for detecting clarithromycin resistance. This study demonstrates that clarithromycin resistance, rather than infection burden, treatment regimen, or duration, drives eradication failure in New Zealand. Tailored therapy based on molecular resistance testing may enhance treatment success and support antibiotic stewardship. These findings justify the development of PCR-guided treatment pathways and provide a strong rationale for extending this approach to non-invasive stool-based testing suitable for use in primary care and screening programs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.70075","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145172044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resilience of the Gut Microbiome to Short Proton Pump Inhibitor Therapy With or Without High-Dosage L. reuteri in H. pylori-Infected Adults","authors":"Stefano Bibbò,&nbsp;Gustav Ahlström,&nbsp;Giovanni Mario Pes,&nbsp;David Y. Graham,&nbsp;Lars Engstrand,&nbsp;Elettra Merola,&nbsp;Maria Pina Dore","doi":"10.1111/hel.70064","DOIUrl":"10.1111/hel.70064","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p><i>Helicobacter pylori</i> eradication therapy typically consists of a combination of antibiotics and an antisecretory drug. Probiotics may be added to reduce side effects and possibly improve outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We conducted a double-blind, randomized trial of pantoprazole plus either <i>Lactobacillus reuteri</i> (Gastrus) (high dose) or a matching placebo to assess the impact on the gut microbiota of <i>H. pylori</i>-positive adults. Fecal samples were collected at baseline and after one and 2 months for shotgun metagenomic sequencing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 26 patients were recruited and completed therapy. <i>L. reuteri</i> was only detected in the group that received supplemental <i>L. reuteri</i> and only at the 1-month post-treatment interval. <i>L. reuteri</i> failed to colonize for long-term the gut, and challenge with <i>L. reuteri</i> failed to alter alpha-diversity (Shannon index) or beta-diversity (community ordination) metrics at any time point. Machine learning (PLS-DA) analysis identified the presence of <i>L. reuteri</i> as the most distinguishing feature at 1 month. No other taxa showed a significant difference between groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Short-term administration of pantoprazole and <i>L. reuteri</i> had no lasting effects on gut microbial composition. While <i>L. reuteri</i> transiently bloomed during supplementation, the overall gut microbiota showed resilience, returning to baseline shortly after therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>Identifier: NCT03404440</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.70064","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overall and Stratified Accuracies of H. pylori Serology Testing: A Multicenter Study of 8497 Screening-Naïve Adults","authors":"Mei-Jyh Chen,&nbsp;Yu-Jen Fang,&nbsp;Chien-Chuan Chen,&nbsp;Chieh-Chang Chen,&nbsp;Jiing-Chyuan Luo,&nbsp;Ming-Jong Bair,&nbsp;Po-Yueh Chen,&nbsp;Chu-Kuang Chou,&nbsp;Ji-Yuh Lee,&nbsp;Tsung-Hua Yang,&nbsp;Jian-Jyun Yu,&nbsp;Chia-Chi Kuo,&nbsp;Min-Chin Chiu,&nbsp;Chi-Yi Chen,&nbsp;Chia-Tung Shun,&nbsp;Wen-Hao Hu,&nbsp;Min-Horn Tsai,&nbsp;Yao-Chun Hsu,&nbsp;Cheng-Hao Tseng,&nbsp;Chi-Yang Chang,&nbsp;Jaw-Town Lin,&nbsp;Emad M. El-Omar,&nbsp;Yi-Chia Lee,&nbsp;Ming-Shiang Wu,&nbsp;Jyh-Ming Liou,&nbsp;the Taiwan Gastrointestinal Disease and Helicobacter Consortium","doi":"10.1111/hel.70074","DOIUrl":"https://doi.org/10.1111/hel.70074","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Population-based <i>Helicobacter pylori</i> screening is a promising strategy for gastric cancer prevention in high-prevalence regions. Although serology is recommended for treatment-naïve individuals, its accuracy in large-scale screening remains uncertain. This multicenter study evaluated serology against biopsy-based tests and assessed the influence of age and atrophic status to inform stratified screening policies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>In this multicenter diagnostic study, 8497 treatment-naïve adults undergoing upper endoscopy across nine hospitals in Taiwan were tested for <i>H. pylori</i> using serology, rapid urease test (RUT), histology, and culture. Serum pepsinogen I and II levels were measured to define serological atrophic gastritis (AG). Diagnostic performance was assessed against a composite reference standard (≥ 2 positive results among RUT, histology, and culture), with subgroup analyses by age and AG status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Serology showed a sensitivity of 94.5% (95% CI: 93.7–95.4) and specificity of 86.0% (95% CI: 85.0–87.0), with a diagnostic odds ratio (DOR) of 106.4. RUT, histology, and culture had higher specificities (97.1%, 94.3%, and 98.2%, respectively) but lower sensitivities (88.6%, 92.3%, and 90.2%, respectively). In individuals aged ≤ 45 years, serology demonstrated 95.2% sensitivity, 93.1% specificity, and a DOR of 268.9 (95% CI: 183.4–394.3). Among participants with AG, serologic specificity declined to 62.4% (95% CI: 53.3–71.5) versus 87.2% (95% CI: 86.0–88.5) in those without AG. The overall negative likelihood ratio was 0.06, and 0.05 among younger adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Serology is an accurate, non-invasive tool for <i>H. pylori</i> detection in younger, treatment-naïve adults without gastric atrophy in high-prevalence regions. In older individuals or those with atrophic gastritis, confirmatory testing is warranted, supporting age-atrophy–based algorithms to optimize screening strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145110707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Helicobacter pylori Pathogenic Factors and Their Interactions With the Gastric Microbiome","authors":"Camilia Metadea Aji Savitri,&nbsp;Takashi Matsumoto,&nbsp;Kartika Afrida Fauzia,&nbsp;Ricky Indra Alfaray,&nbsp;Langgeng Agung Waskito,&nbsp;Yudith Annisa Ayu Rezkitha,&nbsp;Tomohisa Uchida,&nbsp;Muhammad Miftahussurur,&nbsp;Yoshio Yamaoka","doi":"10.1111/hel.70072","DOIUrl":"https://doi.org/10.1111/hel.70072","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Variations in <i>Helicobacter pylori</i> infection rates and pathogenicity do not explain the global gastric cancer incidence, indicating that other bacteria may play a role. We investigated the pathogenic factors of <i>H. pylori</i> and their interactions with the gastric microbiome in a population with low gastric cancer but high gastritis rates in Indonesia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study included 66 <i>H. pylori</i>-positive gastric biopsies. DNA was extracted from the bacterial cultures to examine the pathogenic factors of <i>H. pylori</i>. The 16S rRNA V3–V4 region was sequenced using next-generation sequencing. The microbiome analysis concentrated on α-diversity and β-diversity, along with absolute and relative abundances. Correlation analysis and predicted functional inference were conducted using SECOM and PICRUSt2.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p><i>Helicobacter</i> predominates in <i>H. pylori</i>-infected stomachs, limiting other bacteria. Although α-diversity was non-significant, virulent <i>H. pylori</i> genotypes showed greater microbial diversity, suggesting co-colonization by other taxa. Some taxa were notably abundant across pathogenic subtypes (<i>p</i> &lt; 0.05), such as <i>Veillonella</i> sp. in East Asian-type CagA <i>H. pylori</i> and <i>Klebsiella</i> without <i>babB</i>. The β-diversity results indicated that microbial diversity and abundance varied according to polymorphisms in patients with different <i>H. pylori</i> CagA types, <i>sabA</i> status, <i>homA/B</i>, and <i>iceA</i> subtypes (PERMANOVA test; <i>p</i> &lt; 0.05). <i>H. pylori</i> dominance remains unchanged when atrophy worsens, alongside decreased microbial diversity (<i>p</i> &lt; 0.05 for atrophy stage 0 vs. stages 1 and 2). Microbial correlation analysis revealed that <i>Helicobacter</i> only had a positive linear relationship with <i>Veillonella</i> (SECOM(Pearson2) = 0.51, SECOM(Distance) = 0.60), whereas <i>Streptococcus</i> sp. correlated with several gastric taxa. Predicted functional inference showed several pathways to be depleted when atrophy progresses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Various pathogenic factors impact microbial diversity, and bacteria cohabiting in the gastric environment might shape disease outcomes. Additionally, our study uncovers relationships among genera present in the stomach. More research is needed to explore how non-<i>Helicobacter</i> species induce or possibly safeguard against gastric pathologies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145110706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a FIT Based Colorectal Cancer Screening Program on Gastric Cancer Incidence, Early Diagnosis and Patients' Survival","authors":"João Carlos Silva,&nbsp;Pedro Leite-Silva,&nbsp;Fernando Tavares,&nbsp;Maria José Bento,&nbsp;Diogo Libânio,&nbsp;Mário Dinis-Ribeiro","doi":"10.1111/hel.70071","DOIUrl":"https://doi.org/10.1111/hel.70071","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>In countries with an intermediate incidence of gastric cancer (GC), it has been suggested that offering an upper gastrointestinal endoscopy (UGIE) to individuals referred for a screening colonoscopy following a positive result in the fecal immunochemical test (FIT) may be cost-effective. This study was designed to evaluate the impact of a FIT-based screening program on GC incidence, early diagnosis, and mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Population-based retrospective cohort study in northern Portugal. Data on GC cases were retrieved from the Portuguese National Cancer Registry (RON). GC stage at diagnosis (with early stages defined as T1) and net survival estimates were compared between 2014 and 2016 and the first 3 years of the FIT-based screening program (2018–2020), during which 165,967 tests were performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The odds of GC detection were significantly higher among FIT-positive individuals compared to those with a negative result (OR = 2.87; 95% CI: 1.76–4.49). Of the 10,372 individuals who completed FIT screening and underwent colonoscopy, 51% (<i>n</i> = 5281) also underwent UGIE. The proportion of early-stage diagnoses increased by 14% (95% CI: 12–15), and 3-year net survival improved from 42% (95% CI: 40–43) to 48% (95% CI: 47–50).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Despite the absence of a formal GC screening program, more than half of FIT-screened individuals who underwent colonoscopy also underwent UGIE. The period following the implementation of FIT-based screening was associated with increased early-stage detection and improved survival. These findings support the potential value of offering UGIE combined with colonoscopy for FIT-positive individuals, at least in regions with intermediate GC incidence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145038446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multi-Omics Analysis Revealed Characterization of Gastric Microbiome and Metabolome in Helicobacter pylori-Induced Progression of MASLD","authors":"Han Chen,&nbsp;Yan Wang,&nbsp;Yuting Shao,&nbsp;Wei Su,&nbsp;Shuo Li,&nbsp;Yun Liu,&nbsp;Xiaoying Zhou","doi":"10.1111/hel.70069","DOIUrl":"https://doi.org/10.1111/hel.70069","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Several clinical studies have demonstrated that <i>Helicobacter pylori</i> (Hp) infection may exacerbate the progression of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD); however, the underlying mechanisms remain unclear. This study aims to investigate the characterization of the gastric microbiome and metabolome in relation to the progression of MASLD induced by Hp infection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We established a high-fat diet (HFD) obese mouse model, both with and without Hp infection, to compare alterations in serum and liver metabolic phenotypes. Subsequently, a multi-omics analysis was performed, combining gastric 16S rRNA amplicon sequencing, targeted energy metabolomics, and liver metabolomics sequencing to investigate the correlations among gastric microbiota, energy metabolism, and hepatic metabolism following Hp infection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>HFD mice infected with Hp exhibited a more severe liver steatosis phenotype compared with Hp-negative controls. Hp infection triggers gastric dysbiosis, resulting in a notable enrichment of the <i>Helicobacter</i> genus, which subsequently becomes the dominant bacterial community. This shift leads to a significant rise in the abundance of other bacteria, such as <i>Enterococcus, Streptococcus</i>, and <i>Staphylococcus</i>, while concurrently reducing beneficial bacterial taxa such as <i>Bifidobacterium</i>. Analysis of bacterial functional enrichment and gastric energy metabolomics consistently reveals elevated glycolytic pathway activity in gastric tissue following Hp infection. Furthermore, liver metabolomics indicate increased activities of both glycolytic and lipid metabolic pathways in the liver. The disturbance of the gastric microbiota–metabolism axis is significantly and positively correlated with the hepatic lactate content and severity of hepatic steatosis and inflammation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Hp infection may influence liver metabolism through microbial-metabolic interactions within the gastrohepatic axis, potentially exacerbating the progression of hepatic steatosis. Further studies are necessary to verify these potential causal relationships.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145012439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ten-Day Versus 14-Day Vonoprazan and Amoxicillin Dual Therapy for the Firstline Eradication of Helicobacter pylori Infection: A Multicenter, Randomized Controlled Trial","authors":"Zhiqiang Song,&nbsp;Xiuli Zuo,&nbsp;Zhenyu Zhang,&nbsp;Xuehong Wang,&nbsp;Ya Lin,&nbsp;Yueyue Li,&nbsp;Xiaojun Xu,&nbsp;Yun Huang,&nbsp;Qiuyan Wang,&nbsp;Yanyan Shi,&nbsp;Liya Zhou","doi":"10.1111/hel.70070","DOIUrl":"https://doi.org/10.1111/hel.70070","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The optimal duration for vonoprazan and amoxicillin dual therapy (VA-DT) remains unclear, and studies on gastric acid suppression of vonoprazan during eradication are still lacking.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study conducted a multicenter, randomized controlled trial to compare the eradication efficacy between 10 and 14-day VA-DT, and to identify the dynamic changes of gastric pH during treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included 418 naïve adult patients with <i>Helicobacter pylori</i> infection, who were randomly divided into 10 or 14-day VA-DT groups (vonoprazan 20 mg twice daily and amoxicillin 1000 mg thrice daily). ¹³C-urea breath tests were conducted at 4–8 weeks after eradication to evaluate the success of treatment. 24-h intragastric pH was monitored in 22 patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ten and 14-day VA-DT demonstrated eradication rates of 83.3% vs. 88.0% (rate difference: −4.8%, 95% confidence interval: −11.6% to −2.0%) in intention-to-treat analysis, 87.9% vs. 93.9% (−6.0%, −11.9% to −0.3%) in modified intention-to-treat analysis, and 89.1% vs. 95.3% (−6.1%, −11.8% to −0.7%) in per-protocol analysis, respectively. Vonoprazan showed excellent gastric acid suppression during eradication, with the time percentages of pH &gt; 6 at 75.3% and 97.2% and the median pH levels at 7.4 and 7.8 on the 1st and 7th days, respectively. Furthermore, gastric pH exceeded 6 approximately 4–5 h after the first dose and remained stable at 7–9 thereafter.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The noninferiority of eradication efficacy between 10- and 14-day VA-DT in the first-line treatment was not established, indicating that 10-day therapy cannot be used as a substitute for 14-day therapy. Vonoprazan exerted excellent gastric acid suppression during eradication.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>Chinese Clinical Trial Registry: ChiCTR2200057625</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144998731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Helicobacter pylori Infection and Metachronous Gastric Cancer in Elderly Patients With Gastric Cancer Aged ≥ 75 Years Who Underwent Endoscopic Submucosal Dissection","authors":"Young-Il Kim,&nbsp;Jong Yeul Lee,&nbsp;Chan Gyoo Kim,&nbsp;Il Ju Choi","doi":"10.1111/hel.70068","DOIUrl":"https://doi.org/10.1111/hel.70068","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p><i>Helicobacter pylori</i> (<i>Hp</i>) infection is associated with metachronous gastric cancer (GC) after endoscopic submucosal dissection resection (ESD) in patients with early GC (EGC), but this association has not been well investigated in elderly patients. This study investigated whether <i>Hp</i> infection status was associated with metachronous GC after ESD in patients aged ≥ 75 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study involved 298 EGC patients aged ≥ 75 years who underwent ESD. The <i>Hp</i>-negative group (<i>n</i> = 233) included patients with negative or eradicated <i>Hp</i> infection, whereas the <i>Hp</i>-positive group (<i>n</i> = 65) included patients with persistently positive infection or failed eradication. The primary outcome was metachronous GC occurring at ≥ 1 year after ESD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median patient age was 78 years (interquartile range [IQR]: 76–80 years). During a median follow-up of 4.4 years (IQR: 2.9–5.9 years), metachronous GC occurred in 16 (6.9% [16/233], 16.3 cases/1000 person-year) and 10 (15.4% [10/65], 37.5 cases/1000 person-year) patients in the <i>Hp</i>-negative and <i>Hp</i>-positive groups, respectively. The incidence of metachronous cancer was higher in the <i>Hp</i>-positive group than in the <i>Hp</i>-negative group (<i>p</i> = 0.035, log-rank test). In a multivariate analysis, persistent <i>Hp</i> infection was an independent risk factor for metachronous GC (age- and sex-adjusted hazard ratio, 2.33; 95% CI: 1.05–5.17).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Persistent <i>H. pylori</i> infection status was associated with a higher risk of metachronous GC, and <i>H. pylori</i> treatment needs to be provided in elderly patients aged ≥ 75 years and older with EGC undergoing ESD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 4","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.70068","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144927500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}