Effectiveness of first and second‐line empirical treatment in Italy: Results of the European registry on <i>Helicobacter pylori</i> management

Gatta, Luigi; Nyssen, Olga P.; Fiorini, Giulia; Saracino, Ilaria Maria; Pavoni, Matteo; Romano, Marco; Gravina, Antonietta Gerarda; Granata, L.; Pellicano, Rinaldo; Gasbarrini, Antonio; Leo, Alfredo Di; Losurdo, Giuseppe; Franceschi, Francesco; Nardone, Gerardo; Rocco, Alba; Dore, Maria Pina; Farinati, Fabio; Ghisa, Matteo; Bellini, Massimo; Holton, John; Puig, Ignasi; Vaira, Dino; Borghi, Claudio; Mégraud, Françis; O’Moráin, Colm; Gisbert, Javier P.

doi:10.1002/ueg2.12348

Cited by 10 publications

(5 citation statements)

References 53 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The clustering also offered valuable information to confirm that in those clusters with the highest effectiveness, the therapeutic schemes with the highest content were as follows: BsQuad-MTcB, conco-CAM/T, seq-CAM/T, quadruple-CAB, and triple-CA/M, in all cases prescribed during at least 10 days and combined with standard doses of PPIs (that is, 40 mg omeprazole twice a day). This is in accordance with the literature, as reported in the last VI Maastricht Consensus Guidelines [4], as well as in previous studies of the Hp-EuReg [7,[13][14][15][16][17].…”

Section: Discussionsupporting

confidence: 93%

“…The quadruple-CAB, also prescribed during 14 days and with standard PPI doses in Russia, achieved the highest effectiveness [ 14 ]. In addition, the seq-CAM/T mainly included the Italian cases, where this therapy was given during 10 days and with standard or high-doses of PPIs, also in accordance with local studies [ 17 ]. Finally, conco-CAM/T and BsQuad-MTcB was mostly prescribed during at least 10 days and with low-dose PPIs, with the highest use in Spain, likewise in agreement with previous Spanish Consensus guidelines [ 20 ] and previous published local studies of the Hp-EuReg [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Analysis of Clinical Phenotypes through Machine Learning of First-Line H. pylori Treatment in Europe during the Period 2013–2022: Data from the European Registry on H. pylori Management (Hp-EuReg)

Nyssen,

Pratesi,

Spínola

et al. 2023

Antibiotics

Self Cite

View full text Add to dashboard Cite

The segmentation of patients into homogeneous groups could help to improve eradication therapy effectiveness. Our aim was to determine the most important treatment strategies used in Europe, to evaluate first-line treatment effectiveness according to year and country. Data collection: All first-line empirical treatments registered at AEGREDCap in the European Registry on Helicobacter pylori management (Hp-EuReg) from June 2013 to November 2022. A Boruta method determined the “most important” variables related to treatment effectiveness. Data clustering was performed through multi-correspondence analysis of the resulting six most important variables for every year in the 2013–2022 period. Based on 35,852 patients, the average overall treatment effectiveness increased from 87% in 2013 to 93% in 2022. The lowest effectiveness (80%) was obtained in 2016 in cluster #3 encompassing Slovenia, Lithuania, Latvia, and Russia, treated with 7-day triple therapy with amoxicillin–clarithromycin (92% of cases). The highest effectiveness (95%) was achieved in 2022, mostly in Spain (81%), with the bismuth–quadruple therapy, including the single-capsule (64%) and the concomitant treatment with clarithromycin–amoxicillin–metronidazole/tinidazole (34%) with 10 (69%) and 14 (32%) days. Cluster analysis allowed for the identification of patients in homogeneous treatment groups assessing the effectiveness of different first-line treatments depending on therapy scheme, adherence, country, and prescription year.

show abstract

Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Analysis of Clinical Phenotypes through Machine Learning of First-Line H. pylori Treatment in Europe during the Period 2013–2022: Data from the European Registry on H. pylori Management (Hp-EuReg)

Nyssen,

Pratesi,

Spínola

et al. 2023

Antibiotics

Self Cite

View full text Add to dashboard Cite

show abstract

“…When using bismuth-based quadruple therapy as a first-line therapy, at least 10 days are needed to achieve an eradication rate of >90%. 20 Therefore, in this study, a 10-day regimen was administered when the body weight was below 70 kg. As a result, both the 10-day and 14-day groups achieved eradication rates over 90%.…”

Section: Discussionmentioning

confidence: 99%

Twice‐daily intake of bismuth‐based quadruple therapy for first‐line Helicobacter pylori eradication: A retrospective study on 10‐day, 14‐day, and half‐dose antibiotic therapy

et al. 2023

View full text Add to dashboard Cite

Background/Aims: In areas with >15% clarithromycin resistance, bismuth-based quadruple therapy is recommended for first-line Helicobacter pylori eradication. This study aimed to determine the efficacy of the twice-daily intake of bismuth-based quadruple therapy among 10-day, 14-day, and half-dose antibiotic regimens. Methods:From May 2021 to March 2023, H. pylori-infected Korean adults were administered tetracycline (1 g), metronidazole (750 mg), bismuth potassium citrate (300 mg), and lansoprazole (30 mg) twice daily, after breakfast and dinner, for 10 days.The regimen was administered for 14 days if the body weight was ≥70 kg or if the patient had reinfection. Half doses of antibiotics were administered for 14 days if there was a risk of drug interactions or if the patient was aged ≥75 years. The 13 C-urea breath test was performed after 6 weeks.Results: Among the 1258 infected Koreans, 85.1% (412/484) in the 10-day, 84.3% (498/591) in the 14-day, and 86.3% (158/183) in the half-dose antibiotic groups followed the instructions. In the per-protocol (PP) analysis, eradication rates were higher in the 10-day (90.5%, p = 0.019) and 14-day (90.2%, p = 0.023) groups than in the halfdose group (83.5%). In the intention-to-treat (ITT) analysis, eradication rates were higher in the 10-day group (80.6%) than in the half-dose group (73.2%, p = 0.039). In the half-dose group, the eradication rate was lower in patients aged ≥75 years (PP: 74.6%, ITT: 66.2%) than in those with a risk of drug interactions (PP: 89.7% [p = 0.017], ITT: 82.4% [p = 0.019]).Conclusions: Twice-daily intake of bismuth-based quadruple therapy for 10-14 days showed an eradication rate of >90% in the PP analysis. A 10-day regimen could be administered to eradication-naive patients with a body weight below 70 kg. A half-dose antibiotic regimen might be recommended to patients with a risk of drug interactions but not to those aged ≥75 years simply due to old age.

show abstract

“…Italian guidelines also suggest sequential therapy as an alternative to CT and BQT [13]. Indeed, the Italian data from the European registry on Helicobacter pylori management confirmed that, as first-line treatment, these three strategies show effectiveness of >90% [14].…”

Section: Introductionmentioning

confidence: 98%

Concomitant and Bismuth Quadruple Therapy for Helicobacter pylori Eradication in Southern Italy: Preliminary Data from a Randomized Clinical Trial

Losurdo,

Borraccino,

Aloisio

et al. 2024

Antibiotics

Self Cite

View full text Add to dashboard Cite

Concomitant therapy (CT) and bismuth quadruple therapy (BQT) are recommended in geographical areas with high clarithromycin resistance for Helicobacter pylori (H. pylori) eradication. We compared CT and BQT as the first lines of treatment in a randomized controlled trial. Consecutive patients with H. pylori diagnosed by concordance of both a urea breath test and histology were recruited. For BQT, patients received 3 PyleraTM capsules q.i.d.; for CT, 1000 mg of amoxicillin b.i.d, 500 mg of clarithromycin b.i.d and 500 mg of metronidazole b.i.d. As a proton pump inhibitor, 40 mg of pantoprazole b.i.d was administered. Both regimens lasted 10 days. In total, 46 patients received CT and 38 BQT. Both groups were comparable for age (p = 0.27) and sex (p = 0.36). We did not record any drop outs; therefore, the intention to treat and per protocol rates coincided. The most common symptoms were heartburn and post-prandial fullness, which were equally present in both groups. The success rate was 95.6% for CT and 100% for BQT (p = 0.56). Side effects were recorded in 23.9% and 31.6% of patients in the CT and BQT arms, respectively (p = 0.47). The most common ones were abdominal pain (8) and diarrhea (6). In conclusion, CT and BQT are equally effective in our area with high clarithromycin resistance, southern Italy, and showed comparable safety.

show abstract

Effectiveness of first and second‐line empirical treatment in Italy: Results of the European registry on Helicobacter pylori management

Cited by 10 publications

References 53 publications

Analysis of Clinical Phenotypes through Machine Learning of First-Line H. pylori Treatment in Europe during the Period 2013–2022: Data from the European Registry on H. pylori Management (Hp-EuReg)

Analysis of Clinical Phenotypes through Machine Learning of First-Line H. pylori Treatment in Europe during the Period 2013–2022: Data from the European Registry on H. pylori Management (Hp-EuReg)

Twice‐daily intake of bismuth‐based quadruple therapy for first‐line Helicobacter pylori eradication: A retrospective study on 10‐day, 14‐day, and half‐dose antibiotic therapy

Concomitant and Bismuth Quadruple Therapy for Helicobacter pylori Eradication in Southern Italy: Preliminary Data from a Randomized Clinical Trial

Contact Info

Product

Resources

About