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PubMed

Záznam pochází z PubMed

Empirical Second-Line Therapy in 5000 Patients of the European Registry on Helicobacter pylori Management (Hp-EuReg)

Clinical gastroenterology and hepatology. 2022 Oct ; 20 (10) : 2243-2257. [epub] 20211223

Clin Gastroenterol Hepatol
ISSN 1542-7714 | 1542-3565
Zdroj

Jazyk angličtina Země Spojené státy americké Médium print-electronic

Typ dokumentu časopisecké články, multicentrická studie, práce podpořená grantem

Perzistentní odkaz https://www.medvik.cz/link/pmid34954341

PubMed 34954341
DOI 10.1016/j.cgh.2021.12.025
PII: S1542-3565(21)01349-5
Knihovny.cz E-zdroje

Klíčová slova
Bismuth, Clarithromycin, Helicobacter pylori, Levofloxacin, Rescue,
MeSH
amoxicilin MeSH
antibakteriální látky terapeutické užití MeSH
bismut MeSH
chinolony * terapeutické užití MeSH
dospělí MeSH
Helicobacter pylori * MeSH
infekce vyvolané Helicobacter pylori * farmakoterapie MeSH
inhibitory protonové pumpy MeSH
klarithromycin terapeutické užití MeSH
kombinovaná farmakoterapie MeSH
levofloxacin MeSH
lidé MeSH
moxifloxacin terapeutické užití MeSH
peniciliny škodlivé účinky MeSH
prospektivní studie MeSH
registrace MeSH
tetracyklin terapeutické užití MeSH
Check Tag
dospělí MeSH
lidé MeSH
Publikační typ
časopisecké články MeSH
multicentrická studie MeSH
práce podpořená grantem MeSH
Názvy látek
amoxicilin MeSH
antibakteriální látky MeSH
bismut MeSH
chinolony * MeSH
inhibitory protonové pumpy MeSH
klarithromycin MeSH
levofloxacin MeSH
moxifloxacin MeSH
peniciliny MeSH
tetracyklin MeSH

BACKGROUND & AIMS: After a first Helicobacter pylori eradication attempt, approximately 20% of patients will remain infected. The aim of the current study was to assess the effectiveness and safety of second-line empiric treatment in Europe. METHODS: This international, multicenter, prospective, non-interventional registry aimed to evaluate the decisions and outcomes of H pylori management by European gastroenterologists. All infected adult cases with a previous eradication treatment attempt were registered with the Spanish Association of Gastroenterology-Research Electronic Data Capture until February 2021. Patients allergic to penicillin and those who received susceptibility-guided therapy were excluded. Data monitoring was performed to ensure data quality. RESULTS: Overall, 5055 patients received empiric second-line treatment. Triple therapy with amoxicillin and levofloxacin was prescribed most commonly (33%). The overall effectiveness was 82% by modified intention-to-treat analysis and 83% in the per-protocol population. After failure of first-line clarithromycin-containing treatment, optimal eradication (>90%) was obtained with moxifloxacin-containing triple therapy or levofloxacin-containing quadruple therapy (with bismuth). In patients receiving triple therapy containing levofloxacin or moxifloxacin, and levofloxacin-bismuth quadruple treatment, cure rates were optimized with 14-day regimens using high doses of proton pump inhibitors. However, 3-in-1 single capsule or levofloxacin-bismuth quadruple therapy produced reliable eradication rates regardless of proton pump inhibitor dose, duration of therapy, or previous first-line treatment. The overall incidence of adverse events was 28%, and most (85%) were mild. Three patients developed serious adverse events (0.3%) requiring hospitalization. CONCLUSIONS: Empiric second-line regimens including 14-day quinolone triple therapies, 14-day levofloxacin-bismuth quadruple therapy, 14-day tetracycline-bismuth classic quadruple therapy, and 10-day bismuth quadruple therapy (as a single capsule) provided optimal effectiveness. However, many other second-line treatments evaluated reported low eradication rates. ClincialTrials.gov number: NCT02328131.

Department of Gastroenterology A S Loginov Moscow Clinical Scientific Center Moscow A 1 Yevdokimov Moscow State University of Medicine and Dentistry Moscow Tver State Medical University Tver Russia

Department of Gastroenterology A S Loginov Moscow Clinical Scientific Center Moscow Russia

Department of Gastroenterology Aberdeen Royal Infirmary Aberdeen United Kingdom

Department of Gastroenterology Agencia Sanitaria Costa del Sol Red de Investigación en Servicios de Salud en Enfermedades Crónicas Marbella Spain

Department of Gastroenterology Althaia Xarxa Assistencial Universitària de Manresa Universitat de Vic Universitat Central de Catalunya Manresa Spain

Department of Gastroenterology AM DC Rogaska Rogaska Slatina Slovenia

Department of Gastroenterology and Internal Medicine Department of Surgery University Hospital Brno Faculty of Medicine Masaryk University Brno Czech Republic

Department of Gastroenterology Centre Hospitalier Universitaire de Charleroi Charleroi Belgium

Department of Gastroenterology Centro Hospitalar do Porto Institute of Biomedical Sciences Abel Salazar Centro de Investigação em Tecnologias e Serviços de Saúde University of Porto Porto Portugal

Department of Gastroenterology Chelyabinsk Regional Clinical Hospital Chelyabinsk Russia

Department of Gastroenterology Clinical Center of Serbia University of Belgrade School of Medicine Belgrade Serbia

Department of Gastroenterology Clinical Medicine Zealand University Hospital Copenhagen University Copenhagen Denmark