Dataset Information

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

ABSTRACT: The management of Helicobacter pylori infection has to rely on previous local effectiveness due to the geographical variability of antibiotic resistance. The aim of this study was to evaluate the effectiveness of first and second-line H. pylori treatment in Spain, where the empirical prescription is recommended. A multicentre prospective non-interventional registry of the clinical practice of European gastroenterologists concerning H. pylori infection (Hp-EuReg) was developed, including patients from 2013 until June 2019. Effectiveness was evaluated descriptively and through a multivariate analysis concerning age, gender, presence of ulcer, proton-pump inhibitor (PPI) dose, therapy duration and compliance. Overall, 53 Spanish hospitals were included, and 10,267 patients received a first-line therapy. The best results were obtained with the 10-day bismuth single-capsule therapy (95% cure rate by intention-to-treat) and with both the 14-day bismuth-clarithromycin quadruple (PPI-bismuth-clarithromycin-amoxicillin, 91%) and the 14-day non-bismuth quadruple concomitant (PPI-clarithromycin-amoxicillin-metronidazole, 92%) therapies. Second-line therapies were prescribed to 2448 patients, with most-effective therapies being the triple quinolone (PPI-amoxicillin-levofloxacin/moxifloxacin) and the bismuth-levofloxacin quadruple schemes (PPI-bismuth-levofloxacin-amoxicillin) prescribed for 14 days (92%, 89% and 90% effectiveness, respectively), and the bismuth single-capsule (10 days, 88.5%). Compliance, longer duration and higher acid inhibition were associated with higher effectiveness. "Optimized" H. pylori therapies achieve over 90% success in Spain.

SUBMITTER: Caldas M

PROVIDER: S-EPMC7823881 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

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

Caldas María M Pérez-Aisa Ángeles Á Castro-Fernández Manuel M Bujanda Luis L Lucendo Alfredo J AJ Rodrigo Luis L Huguet Jose M JM Pérez-Lasala Jorge J Molina-Infante Javier J Barrio Jesús J Fernández-Salazar Luis L Lanas Ángel Á Perona Mónica M Domínguez-Cajal Manuel M Ortuño Juan J Gómez-Rodríguez Blas José BJ Almela Pedro P Botargués Josep María JM Núñez Óscar Ó Modolell Inés I Gómez Judith J Ruiz-Zorrilla Rafael R De la Coba Cristóbal C Huerta Alain A Iyo Eduardo E Pozzati Liliana L Antón Rosario R Barenys Mercé M Angueira Teresa T Fernández-Bermejo Miguel M Campillo Ana A Alcedo Javier J Pajares-Villaroya Ramón R Mego Marianela M Bermejo Fernando F Dominguez-Jiménez José Luis JL Titó Llúcia L Fernández Nuria N Pabón-Carrasco Manuel M Cosme Ángel Á Mata-Romero Pilar P Alcaide Noelia N Ariño Inés I Di Maira Tommaso T Garre Ana A Puig Ignasi I Nyssen Olga P OP Megraud Francis F O'Morain Colm C Gisbert Javier P JP

Antibiotics (Basel, Switzerland) 20201225 1

The management of Helicobacter pylori infection has to rely on previous local effectiveness due to the geographical variability of antibiotic resistance. The aim of this study was to evaluate the effectiveness of first and second-line H. pylori treatment in Spain, where the empirical prescription is recommended. A multicentre prospective non-interventional registry of the clinical practice of European gastroenterologists concerning H. pylori infection (Hp-EuReg) was develope ...[more]

PMID: 33375717

Similar Datasets

Project description:BackgroundThere has been resurgence in the use of bismuth quadruple therapy (proton pump inhibitor, bismuth, tetracycline and metronidazole) for treating Helicobacter pylori infection thanks to a three-in-one single-capsule formulation.ObjectiveTo evaluate the effectiveness and safety of the single-capsule bismuth quadruple therapy.MethodsData were collected in a multicentre, prospective registry of the clinical practice of gastroenterologists on the management of H. pylori infection, where patients were registered at the Asociación Española de Gastroenterologia REDCap database on an electronic case report form until January 2020. Effectiveness by modified intention-to-treat and per-protocol as well as multivariable analysis were performed. Independent factors evaluated were: age, gender, indication, compliance, proton pump inhibitor dose and treatment line.ResultsFinally, 2100 patients were prescribed single-capsule bismuth quadruple therapy following the technical sheet (i.e., three capsules every 6 h for 10 days). The majority of these patients were naive (64%), with an average age of 50 years, 64% women and 16% with peptic ulcer. An overall modified intention-to-treat effectiveness of 92% was achieved. Eradication was over 90% in first-line treatment (95% modified intention-to-treat, n = 1166), and this was maintained as a rescue therapy, both in second (89% modified intention-to-treat, n = 375) and subsequent lines of therapy (third to sixth line: 92% modified intention-to-treat, n = 236). Compliance was the factor most closely associated with treatment effectiveness. Adverse events were generally mild to moderate, and 3% of patients reported a severe adverse event, leading to discontinuation of treatment in 1.7% of cases.ConclusionsSingle-capsule bismuth quadruple therapy achieved H. pylori eradication in approximately 90% of patients in real-world clinical practice, both as a first-line and rescue treatment, with good compliance and a favourable safety profile.

Dataset Information

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

Publications

European Registry on <i>Helicobacter pylori</i> Management: Effectiveness of First and Second-Line Treatment in Spain.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets