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Observational Study
. 2024 Jul-Aug;29(4):e13111.
doi: 10.1111/hel.13111.

Indications of Helicobacter pylori Eradication Treatment and Its Influence on Prescriptions and Effectiveness (Hp-EuReg)

Samuel J Martínez-Domínguez  1   2   3 , Olga P Nyssen  4 , Ángel Lanas  1   2   3 , Enrique Alfaro  1   2   3 , Laimas Jonaitis  5 , Umud Mahmudov  6 , Irina Voynovan  7 , Babayeva Gülüstan  8 , Luis Rodrigo  9 , Giulia Fiorini  10 , Ángeles Perez-Aisa  11 , Javier Tejedor-Tejada  12 , Bojan Tepes  13 , Ludmila Vologzanina  14 , Emin Mammadov  8 , Frode Lerang  15 , Quliyev Fərid Vidadi Oğlu  16 , Natalia V Bakulina  17 , Rustam Abdulkhakov  18 , Ilchishina Tatiana  19 , Thomas J Butler  20 , Aiman Silkanovna Sarsenbaeva  21 , Renate Bumane  22 , Alfredo J Lucendo  23 , Marco Romano  24 , Luis Bujanda  3   25   26 , Sayar R Abdulkhakov  17 , Oleg Zaytsev  27 , Manuel Pabón-Carrasco  28 , Alma Keco-Huerga  28 , Maja Denkovski  29 , Jose M Huguet  30 , Monica Perona  31 , Óscar Núñez  32 , Matteo Pavoni  10 , Galyna Fadieienko  33 , Sergey Alekseenko  34 , Sinead M Smith  35 , Luis Hernández  36 , Juozas Kupcinskas  37 , Dmitry S Bordin  38   39   40 , Mārcis Leja  41 , Antonio Gasbarrini  42 , Oleksiy Gridnyev  33 , Anna Cano-Català  43 , Pablo Parra  4 , Leticia Moreira  44 , Francis Mégraud  45 , Colm O'Morain  46 , Javier P Gisbert  4 ; Hp‐EuReg Investigators
Affiliations
Observational Study

Indications of Helicobacter pylori Eradication Treatment and Its Influence on Prescriptions and Effectiveness (Hp-EuReg)

Samuel J Martínez-Domínguez et al. Helicobacter. 2024 Jul-Aug.

Erratum in

Abstract

Background: The influence of indications for Helicobacter pylori investigation on prescriptions and effectiveness is unknown. The aim of the study was to assess the impact of indications for H. pylori investigation on prescriptions, effectiveness, compliance, and tolerance.

Methods: International, prospective, non-interventional registry of the management of H. pylori infection by European gastroenterologists (Hp-EuReg). Treatment-näive patients registered from 2013 to 2023 at e-CRF AEG-REDCap were analyzed. The effectiveness was assessed by modified intention-to-treat analysis.

Results: Overall, 53,636 treatment-naïve cases from 34 countries were included. Most frequent indications were: dyspepsia with normal endoscopy (49%), non-investigated dyspepsia (20%), duodenal ulcer (11%), gastric ulcer (7.7%), and gastroesophageal reflux disease (GERD) (2.6%). Therapy effectiveness varied by indication: duodenal ulcer (91%), gastric ulcer (90%), preneoplastic lesions (90%), dyspepsia with normal endoscopy (89%), GERD (88%), and non-investigated dyspepsia (87%). Bismuth-metronidazole-tetracycline and clarithromycin-amoxicillin-bismuth quadruple therapies achieved 90% effectiveness in all indications except GERD. Concomitant clarithromycin-amoxicillin-tinidazole/metronidazole reached 90% cure rates except in patients with non-investigated dyspepsia; whereas sequential clarithromycin-amoxicillin-tinidazole/metronidazole proved optimal (≥90%) in patients with gastric ulcer only. Adverse events were higher in patients treated for dyspepsia with normal endoscopy and duodenal ulcer compared with the remaining indications (23% and 28%, p < 0.001). Therapeutic compliance was higher in patients with duodenal ulcer and preneoplastic lesions (98% and 99%, p < 0.001).

Conclusion: In Europe, patients with gastric or duodenal ulcers and preneoplastic lesions showed higher H. pylori treatment effectiveness. Bismuth and non-bismuth quadruple therapies achieved optimal results in almost all indications.

Trial registration: ClinicalTrials.gov identifier: NCT02328131.

Keywords: Helicobacter pylori; compliance; effectiveness; indications; safety.

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References

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