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Comparison of the management of Helicobacter pylori infection between the older and younger European populations
P. Jonaitis, OP. Nyssen, IM. Saracino, G. Fiorini, D. Vaira, Á. Pérez-Aísa, B. Tepes, M. Castro-Fernandez, M. Pabón-Carrasco, A. Keco-Huerga, I. Voynovan, AJ. Lucendo, Á. Lanas, SJ. Martínez-Domínguez, EA. Almajano, L. Rodrigo, L. Vologzanina, N....
Language English Country England, Great Britain
Document type Journal Article, Research Support, Non-U.S. Gov't
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- MeSH
- Hypersensitivity * drug therapy MeSH
- Anti-Bacterial Agents adverse effects MeSH
- Bismuth therapeutic use MeSH
- Helicobacter pylori * MeSH
- Helicobacter Infections * drug therapy epidemiology MeSH
- Proton Pump Inhibitors adverse effects MeSH
- Drug Therapy, Combination MeSH
- Humans MeSH
- Penicillins therapeutic use MeSH
- Aged MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Aged MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
The prevalence of Helicobacter pylori remains high in the older population. Specific age-related peculiarities may impact the outcomes of H. pylori treatment. The aim of the study was to evaluate the diagnostics and effectiveness of H. pylori eradication between the younger and older European populations. "European Registry on H. pylori Management (Hp-EuReg)" data from 2013 to 2022 were analyzed. Patients were divided into older (≥ 60 years) and younger (18-59 years) groups. Modified intention-to-treat (mITT) and per-protocol (PP) analysis was performed. 49,461 patients included of which 14,467 (29%) were older-aged. Concomitant medications and penicillin allergy were more frequent among the older patients. Differences between younger and older populations were observed in treatment duration in first-line treatment and in proton pump inhibitors (PPIs) doses in second-line treatment. The overall incidence of adverse events was lower in the older adults group. The overall first-line treatment mITT effectiveness was 88% in younger and 90% in the older patients (p < 0.05). The overall second-line mITT treatment effectiveness was 84% in both groups. The effectiveness of the most frequent first- and second-line triple therapies was suboptimal (< 90%) in both groups. Optimal efficacy (≥ 90%) was achieved by using bismuth and non-bismuth-based quadruple therapies. In conclusion, the approach to the diagnostics and treatment of H. pylori infection did not generally differ between younger and older patients. Main differences were reported in the concurrent medications, allergy to penicillin and adverse events both in first- and second-line treatment. Optimal effectiveness rates were mostly achieved by using bismuth and non-bismuth-based quadruple therapies. No clinically relevant differences in the effectiveness between the age groups were observed.
A 1 Yevdokimov Moscow State University of Medicine and Dentistry 127473 Moscow Russia
Department of Gastroenterology A S Loginov Moscow Clinical Scientific Center 111123 Moscow Russia
Department of Gastroenterology Aberdeen Royal Infirmary Aberdeen AB25 2ZN UK
Department of Gastroenterology AM DC Rogaska 3250 Rogaska Slatina Slovenia
Department of Gastroenterology CHRU de Nantes Hôpital Hôtel Dieu 44000 Nantes France
Department of Gastroenterology Ferencváros Health Centre 1095 Budapest Hungary
Department of Gastroenterology Gastrocentre 614068 Perm Russia
Department of Gastroenterology Henry Dunant Hospital 115 26 Athens Greece
Department of Gastroenterology Hospital de Valme 41014 Seville Spain
Department of Gastroenterology Hospital General de Tomelloso 13700 Tomelloso Spain
Department of Gastroenterology Interni Oddelek Diagnostic Centre 4260 Bled Slovenia
Department of Gastroenterology Lithuanian University of Health Sciences 50161 Kaunas Lithuania
Department of Gastroenterology Meander Medical Center 3813 TZ Amersfoort The Netherlands
Department of Gastroenterology Medical Microbiology Medical University of Sofia 1431 Sofia Bulgaria
Department of Gastroenterology Østfold Hospital Trust 1714 Grålum Norway
Department of Gastroenterology Otto Von Guericke University 39120 Magdeburg Germany
Department of Gastroenterology Pomeranian Medical University 70 204 Szczecin Poland
Department of Surgical and Medical Sciences IRCCS AOUBO University of Bologna 40138 Bologna Italy
Faculty of Health Sciences Trinity College Dublin Dublin D02PN40 Ireland
Gastroenterology Unit Hospital Universitario Central de Asturias 33011 Oviedo Spain
GOES Research Group Althaia Xarxa Assistencial Universitària de Manresa 08243 Manresa Spain
IIS Aragón y Facultad de Medicina de la Universidad de Zaragoza 50009 Zaragoza Spain
INSERM U1312 Université de Bordeaux 33000 Bordeaux France
Memorial Klinik 1096 Baku Azerbaijan
References provided by Crossref.org
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- $a The prevalence of Helicobacter pylori remains high in the older population. Specific age-related peculiarities may impact the outcomes of H. pylori treatment. The aim of the study was to evaluate the diagnostics and effectiveness of H. pylori eradication between the younger and older European populations. "European Registry on H. pylori Management (Hp-EuReg)" data from 2013 to 2022 were analyzed. Patients were divided into older (≥ 60 years) and younger (18-59 years) groups. Modified intention-to-treat (mITT) and per-protocol (PP) analysis was performed. 49,461 patients included of which 14,467 (29%) were older-aged. Concomitant medications and penicillin allergy were more frequent among the older patients. Differences between younger and older populations were observed in treatment duration in first-line treatment and in proton pump inhibitors (PPIs) doses in second-line treatment. The overall incidence of adverse events was lower in the older adults group. The overall first-line treatment mITT effectiveness was 88% in younger and 90% in the older patients (p < 0.05). The overall second-line mITT treatment effectiveness was 84% in both groups. The effectiveness of the most frequent first- and second-line triple therapies was suboptimal (< 90%) in both groups. Optimal efficacy (≥ 90%) was achieved by using bismuth and non-bismuth-based quadruple therapies. In conclusion, the approach to the diagnostics and treatment of H. pylori infection did not generally differ between younger and older patients. Main differences were reported in the concurrent medications, allergy to penicillin and adverse events both in first- and second-line treatment. Optimal effectiveness rates were mostly achieved by using bismuth and non-bismuth-based quadruple therapies. No clinically relevant differences in the effectiveness between the age groups were observed.
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