III Conferencia Española de Consenso sobre la infección por Helicobacter pylori

Gisbert, Javier P.; Calvet, Xavier; Bermejo, Fernando; Boixeda, D; Bory, Felipe; Bujanda, Luís; Castro‐Fernández, Manuel; Domínguez‐Muñoz, Enrique; Elizalde, J. Ignasi; Forné, Montserrat; Gené, Emili; Gomollón, Fernando; Lanas, Fernando; Argila, Carlos Martín de; McNicholl, Adrián G.; Mearin, Fermı́n; Molina–Infante, Javier; Montoro, Miguel; Jm, Pajares García; Pérez-Aísa, Ángeles; Pérez-Trallero, Emilio; Sánchez-Delgado, Jordi

doi:10.1016/j.gastrohep.2013.01.011

Cited by 64 publications

(7 citation statements)

References 296 publications

(182 reference statements)

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“…The accuracy of this marker is suboptimal mainly because of the high range of interpatient variability in its levels. Our results confirm that Hp-ab levels can be indicative of pre-existing exposure to the bacteria, but, in agreement with most clinical guidelines, should not be the method of choice for the diagnosis of current infection 16 , 17 .…”

Section: Discussionsupporting

confidence: 81%

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Accuracy of GastroPanel for the diagnosis of atrophic gastritis

McNicholl

Forné

Barrio

et al. 2014

European Journal of Gastroenterology &Amp; Hepatology

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BackgroundIt has been suggested that GastroPanel might be a useful tool for the diagnosis of chronic atrophic gastritis (CAG) measuring four biomarkers in blood: basal gastrin-17 (G17), pepsinogen I and II (PGI and PGII), and Helicobacter pylori antibodies.AimTo determine the accuracy of GastroPanel for the diagnosis of CAG.MethodsThis was a prospective, blinded, multicenter study that included dyspeptic patients. G17, PGI, and PGII were determined by enzyme immunoassays. Three antrum and two corpus biopsies were obtained for standard histological analysis and rapid urease test. Biopsies were analyzed by a single blinded expert pathologist.ResultsNinety-one patients were included (77% women, mean age 44 years, 51% H. pylori positive, 17% with CAG). G17 was reduced in patients with antrum CAG (5.4 vs. 13.4 pmol/l; P<0.01) and increased in patients with corpus CAG (11 vs. 24 pmol/l; P<0.05), but its accuracy was only acceptable in the case of corpus localization [area under the receiver operating characteristic curve (AUC), 74%]; PGII difference was almost statistically significant only when testing for corpus atrophy (33 vs. 21 μg/l; P=0.05; AUC=72%). The PGI and PGI/PGII ratio showed no significant differences (AUCs were all unacceptably low). Helicobacter pylori antibody levels were higher in H. pylori-infected patients (251 vs. 109 EIU, P=0.01; AUC=70). The accuracy of GastroPanel for the diagnosis of CAG was as follows: sensitivity 50%; specificity 80%; positive 25% and negative 92% predictive values; and positive 2.4 and negative 0.6 likelihood ratios.ConclusionGastroPanel is not accurate enough for the diagnosis of CAG; thus, its systematic use in clinical practice cannot be recommended.

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Section: Discussionsupporting

confidence: 81%

“…Finally, the usefulness of the serological determination of Hp-ab for the diagnosis of H . pylori infection has been questioned previously in the literature 13 , 14 , 16 . The accuracy of this marker is suboptimal mainly because of the high range of interpatient variability in its levels.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of GastroPanel for the diagnosis of atrophic gastritis

McNicholl

Forné

Barrio

et al. 2014

European Journal of Gastroenterology &Amp; Hepatology

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“…The current Clinical Guidelines [7,8] state that PPI should be discontinued at least 2 weeks before testing for H. pylori infection, while antibiotics and bismuth compounds should be discontinued at least 4 weeks before the test. In vitro studies found that high doses of PPI have negative effects on H. pylori viability, inhibiting the growth of isolates and urease activity, with bacterial morphology changing from spiral to coccoid [17,20].…”

Section: Discussionmentioning

confidence: 99%

“…Nowadays, multiple techniques for H. pylori infection diagnosis are available. Depending on if the performance of an endoscopy is needed or not, they are classified as invasive or non-invasive tests [7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

The Validity of the Invasive Tests for Helicobacter Pylori Diagnosis is Unequally Affected by the Consumption of Antibiotics or Pump Inhibitors. Test Performance under Real-World Conditions

Alcedo

Casas

Gotor

et al. 2021

JGLD

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Background and Aims: Patients undergoing upper endoscopy have often used proton pump inhibitors (PPI) and/or antibiotics (ABx) recently. Both drugs have been associated with a poorer yield of the Helicobacter pylori (H. pylori) diagnostic tests. The aim was to assess the accuracy of the polymerase chain reaction test (qPCR), histological exam (HE) and ultra-fast urease test (UFUT) for H. pylori detection in patients that recently used PPI or ABx. Methods: Prospective study recruiting 206 patients who underwent upper endoscopy and gastric biopsies. Demographics and use of PPI/ABx were obtained. Sensibility (Sn), specificity (Sp), predictive value (PV), likelihood ratio (LR) and PABAK concordance index, were calculated, considering as the gold standard the positivity of 2 out of 3 analyzed tests. A global analysis and another one based on the PPI/ABx intake were performed. Results: 48.5% of patients used PPI and 12.8% ABx within the 2 and 4 weeks prior to endoscopy, respectively. The UFUT was positive in 13.1% of patients, HE in 34% and qPCR in 35.9%. UFUT achieved lower Sn (37%) than HE (98%) and qPCR (98%) (p<0.001) overall. ABx were associated with lower Sn in HE (p=0.04) and lower Sp in qPCR (p=0.03). PPI did not associate with a significant drop in Sn and Sp. The concordance between HE and qPCR was 0.83 (95%CI: 0.73-0.89). Conclusions: Under real world conditions, the accuracy and concordance of HE and qPCR to diagnose H. pylori were excellent, but UFUT achieved unsatisfactory outcomes. The intake of ABx was associated with the worse performance, fundamentally for HE. The PPI did not reduce the tests‘ yield significantly.

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“…In H. pylori eradication it is currently recommended to use double doses of PPI to optimize the eradication efficacy (84). A recent meta-analysis has shown that double dose PPI increases cure rate by 8% compared with the use of standard dose (85).…”

Section: Tips To Optimize Ppi Treatmentmentioning

confidence: 99%

Practical considerations in the management of proton-pump inhibitors

Aguilera¹,

Martín-de-Argila-dePrados²,

Albillos-Martínez³

2015

Rev Esp Enferm Dig

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Proton-pump inhibitors (PPIs) are one of the most active ingredients prescribed in Spain. In recent decades there has been an overuse of these drugs in both outpatient clinics and hospitals that has lead to a significant increase in healthcare spending and to an increase in the risk of possible side effects. It is important for health professionals to know the accepted indications and the correct doses for the use of these drugs. On the market there are different types of PPI: omeprazole, pantoprazole, lansoprazole, rabeprazole and esomeprazole. Omeprazole is the oldest and most used PPI, being also the cheapest. Although there are no important differences between PPIs in curing diseases, esomeprazole, a newgeneration PPI, has proved to be more effective in eradicating H. pylori and in healing severe esophagitis compared to other PPIs. In recent years the use of generic drugs has spread; these drugs have the same bioavailability than the original drugs. In the case of PPIs, the few comparative studies available in the literature between original and generic drugs have shown no significant differences in clinical efficacy.Key words: Proton-pump inhibitor. PPI. Omeprazole. Pantoprazole. Lansoprazole. Rabeprazole. Esomeprazole. INTRODUCTIONProton-pump inhibitors (PPIs) represent a family of drugs widely used in our country. The advent in the nineties of PPIs was a great revolution in the treatment of ulcer disease and gastroesophageal reflux. The main problems of PPIs at present time are its overuse and the errors in the therapeutic indication. This fact leads to a considerable health economic cost and the risk of long-term side effects. In this review the main problems of PPIs prescription, their indications, the differences between PPIs and tips on their use are discussed. Brief historical memory: since alkaline diets until PPIsThe treatment of ulcer disease and gastroesophageal reflux disease (GERD) in the early twentieth century was the prescription of alkaline foods like milk, eggs and puree (1). Later, there were products as sodium bicarbonate that improved symptoms but did not prevent complications. Surgical treatment consisted of different types of gastric surgeries for peptic ulcer disease and Nissen fundoplication for GERD (2).In the mid twentieth century the use of muscarinic antagonists was introduced, atropine being its main active ingredient. Acids secretion was partially inhibited by blocking the muscarinic receptor of the parietal cell. However, these drugs had little effectiveness and numerous adverse effects due to the amount of muscarinic receptors distributed throughout the body. E-type prostaglandin was discovered later, but, again, the limitations of these substances were their short half life and side effects. An important progress in gastric antisecretory therapy was the appearance of H 2 receptors antagonists (H 2 blockers) (3). The most used were ranitidine and famotidine. These drugs established a substantial change by blocking the action of histamine receptor in gastric parietal ...

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III Conferencia Española de Consenso sobre la infección por Helicobacter pylori

Cited by 64 publications

References 296 publications

Accuracy of GastroPanel for the diagnosis of atrophic gastritis

Accuracy of GastroPanel for the diagnosis of atrophic gastritis

The Validity of the Invasive Tests for Helicobacter Pylori Diagnosis is Unequally Affected by the Consumption of Antibiotics or Pump Inhibitors. Test Performance under Real-World Conditions

Practical considerations in the management of proton-pump inhibitors

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