6533b831fe1ef96bd129862c
RESEARCH PRODUCT
European Registry on Helicobacter pylori management (Hp-EuReg): patterns and trends in first-line empirical eradication prescription and outcomes of 5 years and 21 533 patients
Nyssen OpBordin DTepes BPérez-aisa ÁVaira DCaldas MBujanda LCastro-fernandez MLerang FLeja MRodrigo LRokkas TKupcinskas LPérez- Lasala JJonaitis LShvets OGasbarrini ASimsek HAxon AtrBuzás GMachado JcNiv YBoyanova LGoldis ALamy VTonkic APrzytulski KBeglinger CVenerito MBytzer PCapelle LMilosavljević TMilivojevic VVeijola LMolina-infante JVologzhanina LFadeenko GAriño IFiorini GGarre AGarrido JF Pérez CPuig IHeluwaert FMegraud FO'morain CGisbert JpRomano Msubject
MaleRegistrieProton Pump InhibitorPractice Patterns0302 clinical medicineClarithromycinProspective StudiesRegistriesPractice Patterns Physicians'[SDV.MHEP] Life Sciences [q-bio]/Human health and pathologybiologyGastroenterologyMiddle AgedAnti-Bacterial Agents3. Good healthEurope030220 oncology & carcinogenesisCombination030211 gastroenterology & hepatologyDrug Therapy CombinationFemalemedicine.drugHumanAdultmedicine.medical_specialtyTRIPLE THERAPY ; QUADRUPLE THERAPY ; CONSENSUS ; INFECTION ; METAANALYSIS ; CLARITHROMYCIN ; GUIDELINES ; RESISTANCE ; ARTICLESettore MED/12 - GASTROENTEROLOGIAFirst lineHelicobacter Infections03 medical and health sciencesDrug TherapyInternal medicineAnti-Bacterial AgentmedicineHumansMedical prescriptionAdverse effectAgedPhysicians'Helicobacter pyloribusiness.industryhelicobacter pylori - treatmentProton Pump InhibitorsAmoxicillinHelicobacter pyloribiology.organism_classificationMetronidazoleProspective StudieConcomitanthelicobacter pyloribusinessHelicobacter Infection[SDV.MHEP]Life Sciences [q-bio]/Human health and pathologydescription
ObjectiveThe best approach for Helicobacter pylori management remains unclear. An audit process is essential to ensure clinical practice is aligned with best standards of care.DesignInternational multicentre prospective non-interventional registry starting in 2013 aimed to evaluate the decisions and outcomes in H. pylori management by European gastroenterologists. Patients were registered in an e-CRF by AEG-REDCap. Variables included demographics, previous eradication attempts, prescribed treatment, adverse events and outcomes. Data monitoring was performed to ensure data quality. Time-trend and geographical analyses were performed.Results30 394 patients from 27 European countries were evaluated and 21 533 (78%) first-line empirical H. pylori treatments were included for analysis. Pretreatment resistance rates were 23% to clarithromycin, 32% to metronidazole and 13% to both. Triple therapy with amoxicillin and clarithromycin was most commonly prescribed (39%), achieving 81.5% modified intention-to-treat eradication rate. Over 90% eradication was obtained only with 10-day bismuth quadruple or 14-day concomitant treatments. Longer treatment duration, higher acid inhibition and compliance were associated with higher eradication rates. Time-trend analysis showed a region-dependent shift in prescriptions including abandoning triple therapies, using higher acid-inhibition and longer treatments, which was associated with an overall effectiveness increase (84%–90%).ConclusionManagement of H. pylori infection by European gastroenterologists is heterogeneous, suboptimal and discrepant with current recommendations. Only quadruple therapies lasting at least 10 days are able to achieve over 90% eradication rates. European recommendations are being slowly and heterogeneously incorporated into routine clinical practice, which was associated with a corresponding increase in effectiveness.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2020-09-21 |