European Registry on Helicobacter pylori Management: Effectiveness of First and Second-Line Treatment in Spain

Caldas, María; Pérez-Aísa, Ángeles; Castro‐Fernández, Manuel; Bujanda, Luís; Lucendo, Alfredo J.; Rodrigo, Luı́s; Huguet, José María; Pérez-Lasala, Jorge; Molina–Infante, Javier; Barrio, Jesús; Fernández-Salazar, Luis; Lanas, Fernando; Perona, Mónica; Domínguez-Cajal, Manuel; Ortuño, Juan; Gomez-Rodriguez, Blas J.; Almela, Pedro; Botargues, Josep M.; Núñez, Óscar; Modolell, Inés; Gómez, J. Gil; Ruiz-Zorrilla, Rafael; Coba, Cristóbal De la; Huerta, Alaín; Iyo, Eduardo; Pozzati, Liliana; Antón, Rosario; Barenys, Mercè; Angueira, Teresa; Fernandez–Bermejo, Miguel; Campillo, Ana; Alcedo, Javier; Pajares-Villaroya, Ramón; Mego, Marianela; Bermejo, Fernando; Domínguez-Jiménez, José Luis; Titó, Llúcia; Fernández, Nuria; Pabón-Carrasco, Manuel; Cosme, Ángel; Mata-Romero, Pilar; Alcaide, Noelia; Ariño, I.; Maira, Tommaso Di; Garre, Ana; Puig, Ignasi; Nyssen, Olga P.; Mégraud, Françis; O’Moráin, Colm; Gisbert, Javier P.

doi:10.3390/antibiotics10010013

Cited by 15 publications

(14 citation statements)

References 39 publications

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“…The sub-analysis of eradication based on the previous first-line regimen confirmed that BQT is effective independently from the previous regimen, and it should be considered after an unsuccessful therapy containing clarithromycin. This finding confirms an observation that has already been proven in the literature [ 22 , 23 ].…”

Section: Discussionsupporting

confidence: 92%

Empiric “Three-in-One” Bismuth Quadruple Therapy for Second-Line Helicobacter pylori Eradication: An Intervention Study in Southern Italy

et al. 2022

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The eradication of Helicobacter pylori (H. pylori) may be difficult due to antibiotic resistance. Indeed, after one failure, a second-line therapy is needed and a bismuth containing quadruple therapy (BQT) with a three-in-one capsule formulation is becoming very popular. Therefore, we aimed to evaluate effectiveness and safety of BQT as a second-line therapy. We recruited consecutive patients with one therapy failure. For ten days patients received the three-in-one BQT Pylera® therapy, in combination with a proton-pump inhibitor (PPI), decided at the choice of the investigator, at full dose bid. The eradication rate was calculated by intention-to-treat (ITT) and per-protocol (PP)analyses and 95% confidence intervals (CI) were calculated. Seventy-three patients were recruited, 41 females and 32 males (mean age 53.0±13.1 years). Fifty-five patients failed triple therapy with amoxicillin and clarithromycin and the remaining 18 received sequential therapy. Seventy-two patients consumed at least 90% of the capsules, while only one did not complete the therapy due to adverse events (nausea and diarrhea). By ITT analysis, BQT was successful in 62 subjects (eradication rate 84.9%, 95%CI 76.7–93.1%). By PP analysis, the eradication rate was 86.1% (95%CI 78.1–94.1%).Adverse events were observed in 14 subjects (20.5%).In conclusion, our report confirmed that BQT is effective as an empiric second-line regimen.

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Section: Discussionsupporting

confidence: 92%

Empiric “Three-in-One” Bismuth Quadruple Therapy for Second-Line Helicobacter pylori Eradication: An Intervention Study in Southern Italy

et al. 2022

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“…Interestingly, although there is a difference in the rate of antibiotic resistance in various geographic areas, BQT shows successful results and is recommended as a first- or second-line therapy in most areas [ 5 , 6 , 7 , 8 , 9 , 22 ]. Recent European data (Hp-EuReg) also showed similar results to this study in second-line BQT [ 23 , 24 ].…”

Section: Discussionsupporting

confidence: 88%

Second-Line Bismuth-Containing Quadruple Therapy for Helicobacterpylori Infection: A 12-Year Study of Annual Eradication Rates

Shin

Cho

et al. 2021

JCM

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Background: Bismuth-containing quadruple therapy (BQT) consisting of a proton-pump inhibitor (PPI), bismuth, metronidazole and tetracycline is recommended as a second-line treatment for Helicobacter pylori (H. pylori) infection when PPI-based standard triple therapy (STT) consisting of a PPI, amoxicillin and clarithromycin is unsuccessful. The purpose of this study was to analyze the long-term results of BQT as a second-line therapy to determine its effectiveness. Methods: This study included 643 subjects who failed first-line STT and received 7 or 10–14 days of BQT as a second-line therapy. We retrospectively analyzed the annual H. pylori eradication rates, demographic factors and adverse events. Results: The overall eradication rates by intention-to-treat (ITT) and per-protocol (PP) analyses were 80.7% (519/643) and 93.3% (519/556), respectively. By PP analysis, the eradication rates for 2008–2011, 2012–2015, and 2016–2019 were 93.3%, 91.0%, and 96.4%, respectively (p = 0.145). There were no significant differences between the 7-day group and the 10–14-day group in both the ITT (79.7% vs. 86.0%, p = 0.148) and the PP analyses (92.7% vs. 96.6%, p = 0.187). A multivariate analysis showed that current smoking was associated with eradication failure. Eighty-nine subjects (16.0%) suffered adverse events, mainly gastrointestinal symptoms, but only six cases were severe. Conclusions: BQT as a second-line therapy is an effective treatment for H. pylori. Treatment for 10–14 days showed a higher eradication rate compared with a 7-day regimen, but not significantly.

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“…To date, 14 studies have been published locally, providing a "country experience". Overall, three studies evaluated data in Spain (19,27,28), one in Greece (42), two in Slovenia (22,37), one in Lithuania (38), one in Israel (39), five in Russia (20, 21, 23, 29, 30), and one in Hungary (24). A synthesis of the most relevant conclusions from these studies is also reported in Table 2.…”

Section: Local Data By Countrymentioning

confidence: 99%

European Registry on Helicobacter pylori Management (Hp-EuReg): Most relevant results for clinical practice

Nyssen¹,

Moreira²,

García-Morales³

et al. 2022

Front. Gastroenterol.

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BackgroundThe ideal treatment approach for H. pylori infection has not yet been defined; therefore, the most effective management strategies for adult patients need to be identified to ensure clinical practice is aligned with the best standard of care. Our aim was to perform a review of research studies from the European Registry on H. pylori management (Hp-EuReg) by synthesizing the most clinically relevant information from each published manuscript.MethodsAll research studies published between 2013 and 2022, evaluating any information related to H. pylori infection management within the Hp-EuReg, a long-term registry of routine clinical practice by gastroenterologists in Europe, were included in the review.ResultsOverall, 26 studies have been published to date, where 12 evaluated the overall European data and the remaining were performed locally among the 28 participating countries. Eighteen studies evaluated the effectiveness of first- and/or second-line treatment, where one focused on penicillin allergic patients, six focused on specific treatment schemes, one evaluated the role of statins as a concomitant drug when combined with the eradication therapy, one assessed the adverse event profile of treatments, one evaluated the bacterial antibiotic resistance trends, and a last one reported on the common mistakes in routine clinical practice of European gastroenterologists.ConclusionThe Hp-EuReg had a major influence on the routine clinical practice of European gastroenterologists, improving H. pylori eradication treatment success, allowing to make recommendations in line with the current consensus guidelines and potentially serving as a model for other diseases.

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European Registry on Helicobacter pylori Management: Effectiveness of First and Second-Line Treatment in Spain

Cited by 15 publications

References 39 publications

Empiric “Three-in-One” Bismuth Quadruple Therapy for Second-Line Helicobacter pylori Eradication: An Intervention Study in Southern Italy

Empiric “Three-in-One” Bismuth Quadruple Therapy for Second-Line Helicobacter pylori Eradication: An Intervention Study in Southern Italy

Second-Line Bismuth-Containing Quadruple Therapy for Helicobacterpylori Infection: A 12-Year Study of Annual Eradication Rates

European Registry on Helicobacter pylori Management (Hp-EuReg): Most relevant results for clinical practice

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