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Experience with Rifabutin-Containing Therapy in 500 Patients from the European Registry on Helicobacter pylori Management (Hp-EuReg).

ABSTRACT: First-line Helicobacter pylori (H. pylori) treatments have been relatively well evaluated; however, it remains necessary to identify the most effective rescue treatments. Our aim was to assess the effectiveness and safety of H. pylori regimens containing rifabutin. International multicentre prospective non-interventional European Registry on H. pylori Management (Hp-EuReg). Patients treated with rifabutin were registered in AEG-REDCap e-CRF from 2013 to 2021. Modified intention-to-treat and per-protocol analyses were performed. Data were subject to quality control. Overall, 500 patients included in the Hp-EuReg were treated with rifabutin (mean age 52 years, 72% female, 63% with dyspepsia, 4% with peptic ulcer). Culture was performed in 63% of cases: dual resistance (to both clarithromycin and metronidazole) was reported in 46% of the cases, and triple resistance (to clarithromycin, metronidazole, and levofloxacin) in 39%. In 87% of cases rifabutin was utilised as part of a triple therapy together with amoxicillin and a proton-pump-inhibitor, and in an additional 6% of the patients, bismuth was added to this triple regimen. Rifabutin was mainly used in second-line (32%), third-line (25%), and fourth-line (27%) regimens, achieving overall 78%, 80% and 66% effectiveness by modified intention-to-treat, respectively. Compliance with treatment was 89%. At least one adverse event was registered in 26% of the patients (most frequently nausea), and one serious adverse event (0.2%) was reported in one patient with leukopenia and thrombocytopenia with fever requiring hospitalisation. Rifabutin-containing therapy represents an effective and safe strategy after one or even several failures of H. pylori eradication treatment.

SUBMITTER: Nyssen OP

PROVIDER: S-EPMC8949410 | biostudies-literature | 2022 Mar

REPOSITORIES: biostudies-literature

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Experience with Rifabutin-Containing Therapy in 500 Patients from the European Registry on <i>Helicobacter pylori</i> Management (Hp-EuReg).

Nyssen Olga P OP Vaira Dino D Saracino Ilaria Maria IM Fiorini Giulia G Caldas María M Bujanda Luis L Pellicano Rinaldo R Keco-Huerga Alma A Pabón-Carrasco Manuel M Oblitas Susanibar Elida E Di Leo Alfredo A Losurdo Giuseppe G Pérez-Aísa Ángeles Á Gasbarrini Antonio A Boltin Doron D Smith Sinead S Phull Perminder P Rokkas Theodore T Lamarque Dominique D Cano-Català Anna A Puig Ignasi I Mégraud Francis F O'Morain Colm C Gisbert Javier P JP

Journal of clinical medicine 20220316 6

<h4>Background</h4>First-line <i>Helicobacter pylori</i> (<i>H. pylori</i>) treatments have been relatively well evaluated; however, it remains necessary to identify the most effective rescue treatments. Our aim was to assess the effectiveness and safety of <i>H. pylori</i> regimens containing rifabutin.<h4>Methods</h4>International multicentre prospective non-interventional European Registry on <i>H. pylori</i> Management (Hp-EuReg). Patients treated with rifabutin were registered in AEG-REDCap ...[more]

PMID: 35329984

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Project description:BackgroundAdherence to Helicobacter pylori (H. pylori) eradication treatment is a cornerstone for achieving adequate treatment efficacy.ObjectiveTo determine which factors influence compliance with treatment.MethodsA systematic prospective non-interventional registry (Hp-EuReg) of the clinical practice of European gastroenterologists. Compliance was considered adequate if ≥90% drug intake. Data were collected until September 2021 using the AEG-REDCap e-CRF and were subjected to quality control. Modified intention-to-treat analyses were performed. Multivariate analysis carried out the factors associated with the effectiveness of treatment and compliance.ResultsCompliance was inadequate in 646 (1.7%) of 38,698 patients. The non-compliance rate was higher in patients prescribed longer regimens (10-, 14-days) and rescue treatments, patients with uninvestigated dyspepsia/functional dyspepsia, and patients reporting adverse effects. Prevalence of non-adherence was lower for first-line treatment than for rescue treatment (1.5% vs. 2.2%; p < 0.001). Differences in non-adherence in the three most frequent first-line treatments were shown: 1.1% with proton pump inhibitor + clarithromycin + amoxicillin; 2.3% with proton pump inhibitor clarithromycin amoxicillin metronidazole; and 1.8% with bismuth quadruple therapy. These treatments were significantly more effective in compliant than in non-compliant patients: 86% versus 44%, 90% versus 71%, and 93% versus 64%, respectively (p < 0.001). In the multivariate analysis, the variable most significantly associated with higher effectiveness was adequate compliance (odds ratio, 6.3 [95%CI, 5.2-7.7]; p < 0.001).ConclusionsCompliance with Helicobacter pylori eradication treatment is very good. Factors associated with poor compliance include uninvestigated/functional dyspepsia, rescue-treatment, prolonged treatment regimens, the presence of adverse events, and the use of non-bismuth sequential and concomitant treatment. Adequate treatment compliance was the variable most closely associated with successful eradication.

Dataset Information

Experience with Rifabutin-Containing Therapy in 500 Patients from the European Registry on Helicobacter pylori Management (Hp-EuReg).

Publications

Experience with Rifabutin-Containing Therapy in 500 Patients from the European Registry on <i>Helicobacter pylori</i> Management (Hp-EuReg).

Similar Datasets

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