Helicobacter pylori management in ASEAN: The Bangkok consensus report

Abstract

Helicobacter pylori (H. pylori) infection remains to be the major cause of important upper gastrointestinal diseases such as chronic gastritis, peptic ulcer, gastric adenocarcinoma, and mucosa-associated lymphoid tissue lymphoma. H. pylori management in ASEAN: the Bangkok consensus report gathered key opinion leaders for the region to review and evaluate clinical aspects of H. pylori infection and to develop consensus statements, rationales, and grades of recommendation for the management of H. pylori infection in clinical practice in ASEAN countries. This ASEAN Consensus consisted of 34 international experts from 10 ASEAN countries, Japan, Taiwan, and the United States. The meeting mainly focused on four issues: (i) epidemiology and disease association; (ii) diagnostic tests; (iii) management; and (iv) follow-up after eradication. The final results of each workshop were presented for consensus voting by all participants. Statements, rationale, and recommendations were developed from the available current evidence to help clinicians in the diagnosis and treatment of H. pylori and its clinical diseases.

Real‐world data of Helicobacter pylori prevalence, eradication regimens, and antibiotic resistance in Thailand, 2013–2018

“…Furthermore, H. pylori is a pathogen known as a definite (group I) carcinogen, 2 and chronic infection because of this pathogen is found to be associated with gastric mucosa-associated lymphoid tissue (MALT) lymphoma, colorectal adenomas, pancreatic cancer, and throat cancer. 4 From this report, it can be seen that the prevalence of gastric cancer in men is gradually increasing. Gastric cancer is one of the top 5 most commonly diagnosed cancers in the world and is one of the top 10 causes of mortality from cancer in most Association of Southeast Asian Nations (ASEAN) countries.…”

“…1,3 According to Thailand's National Cancer Control Programmes, cancer is the most common cause of death in Thailand and is increasing. 4 The report of H. pylori infection prevalence in Thailand is quite variable or somewhat out of date. 4 From this report, it can be seen that the prevalence of gastric cancer in men is gradually increasing.…”

“…5 In addition, the latest prevalence of 43.6% is from a systematic review, "The Global Prevalence of the Helicobacter pylori Infection: systematic review and Meta-Analysis" in 2017. 4 It suggested that the first-line regimen should be based on antibiotic resistance patterns in each area, while the second-line regimen should not contain the same drug as the first-line regimen, and antibiotic susceptibility testing should be performed when there are more than two treatment failures. However, a study with a large number of subjects was conducted from 2008-2009 and demonstrated a prevalence of 27.7%.…”

Relative potency of proton‐pump inhibitors, Helicobacter pylori therapy cure rates, and meaning of double‐dose PPI

“…[15][16][17] The Maastricht V consensus states "increasing the dose of PPI from, for example, 20 mg omeprazole twice daily to 40 mg of esomeprazole or rabeprazole twice daily may increase cure rates by 8%-12%". [15][16][17] The Maastricht V consensus states "increasing the dose of PPI from, for example, 20 mg omeprazole twice daily to 40 mg of esomeprazole or rabeprazole twice daily may increase cure rates by 8%-12%".…”

Smoking and Drinking Did Not Increase the Failure of Therapeutic Helicobacter pylori Eradication by Vonoprazan, Clarithromycin, and Amoxicillin

“…Several diseases are closely related to Helicobacter pylori infection, including chronic gastritis, peptic ulcers, gastric neoplasms, and mucosal-associated lymphoid tissue lymphoma [1][2][3][4][5][6][7]. A number of studies have indicated that the eradication of H. pylori reduces the incidence and prevalence of these diseases [8][9][10][11][12].…”