European Registry on the management of Helicobacter pylori infection: features of diagnosis and treatment in Kazan

Abstract

Background. As part of an observational multicenter prospective study European Registry on the management of Helicobacter pylori infection, conducted on the initiative of the European H. pylori and Microbiota Study Group, the compliance of clinical practice in the management of patients with Helicobacter pylori infection in Kazan with clinical guidelines was assessed.
 Materials and methods. The data of 437 patients included into the register by clinical sites in Kazan in 20132019 were analyzed. The methods used for the initial diagnosis of H. pylori infection and eradication control were evaluated. The frequency of various eradication therapy regimens prescription was analyzed in 379 cases. Data regarding the effectiveness of eradication therapy was analyzed in 173 patients.
 Results. The rapid urease test (44.2% of cases) and cytology/histology (60% of cases) were most often used for the initial diagnosis of H. pylori infection; however non-invasive methods such as 13C-urea breath (9.2%), serology (6.2%), H. pylori stool antigen test (2.3%) were less common. In 21.7% of patients two methods of H. pylori detection were used for primary diagnosis. The control test to evaluate the effectiveness of eradication therapy at the recommended timepoint was performed in 46.2% of patients. 13C-urea breath test (31.7%), stool PCR/stool antigen test (28.7%), rapid urease test (22.3%), cytology/histology (26.2% of cases) prevailed in the assessment of eradication rate. Standard triple therapy, including proton pump inhibitor, clarithromycin and amoxicillin was most commonly prescribed as first-line therapy (64.6% of cases). The duration of eradication therapy was 14 days in the majority of cases with pantoprazole as the most common proton pump inhibitor in standard triple therapy regimens (84.8%). The efficacy of 14-day standard triple therapy (mITT) was 87.0%.
 Conclusion. The results indicate a high frequency of non-invasive methods use for assessing the effectiveness of eradication therapy; however, the overall rate of eradication efficacy assessment is low, limiting the possibility of analyzing the eradication results. The effectiveness of the most common 14-day standard triple first-line therapy in Kazan doesnt reach the recommended 90% eradication level. This could be explained by high rate of pantoprazole use, which is not an optimal proton pump inhibitor in eradication therapy regimens.

Helicobacter pylori infection prevalence in ambulatory settings in 2017–2019 in RUSSIA: The data of real‐world national multicenter trial

“…Many studies showed that no more than 46.2% of treated subjects tested after eradication therapy. 9,13,35,36 Although the data of the present study reflects the real-world data, it has some limitations related to its nature. This study was not designed to assess the prevalence of H. pylori infection in different age with the use of standard epidemiological approaches, when number of infected persons is assessed in random samples, normalized by age and sex distribution similar to the general population of a certain region.…”

“…However, the previously published data, suggesting that the efficacy of the most widely used standard first‐line eradication therapy reaches 80% by mITT, 9,35 but re‐treatment of patients who did not achieve eradication is rare due to low number of the control tests. Many studies showed that no more than 46.2% of treated subjects tested after eradication therapy 9,13,35,36 …”

Evaluation of the Effectiveness of Helicobacter pylori Eradication Regimens in Lithuania during the Years 2013–2020: Data from the European Registry on Helicobacter pylori Management (Hp-EuReg)

“…Similar studies have been performed in other Central and Eastern European countries and the results are diverse. The results in Kazan (Russia) have also shown a low follow-up after the eradication treatment as well as suboptimal (<90%) treatment effectiveness even in 14 days duration standard triple therapy [ 42 ]. Another Russian study concluded that the success rate of the most popular 10 days duration standard triple therapy was only 79% during the years 2013–2018 and serological test were still used for the evaluation of treatment effectiveness [ 43 ].…”

Errors in the diagnosis and treatment of <i>Helicobacter pylori</i> infection: in anticipation of new conciliation documents

“…Антитела IgG к H.pylori в крови оценивались у 6,2% больных, 13 С-УДТ -у 9,2%, определение антигена H.pylori в стуле -у 2,3% пациентов. В 21,7% случаев для первичной диагностики были использованы 2 метода [35]. Наблюд ательное исследование, проведенное в Москве и Санкт-Петербурге, так же продемонстрировало, что для первичной диагностики H. pylori чаще применялись инвазивные методы: БУТ в 37,9% случаев, гистологическая оценка -в 19%.…”

“…Серологический метод использован в 0,6% наблюдении [34]. В Казани контрольный тест в рекомендованные сроки был проведен у 46% пациентов, антитела определялись в 2% случаев [35]. По данным другого исследования, в Москве серологический тест использовали 1,6% гастроэнтерологов, в Санкт-Петербурге -0,3% [36].…”