Evolution of the use, effectiveness and safety of bismuth-containing quadruple therapy for Helicobacter pylori infection between 2013 and 2021: results from the European registry on H. pylori management (Hp-EuReg)
Language English Country Great Britain, England Media electronic
Document type Journal Article, Observational Study
PubMed
39461739
PubMed Central
PMC11671959
DOI
10.1136/gutjnl-2024-332804
PII: gutjnl-2024-332804
Knihovny.cz E-resources
- Keywords
- ANTIBIOTIC THERAPY, HELICOBACTER PYLORI - TREATMENT, HELICOBACTER THERAPY,
- MeSH
- Amoxicillin therapeutic use administration & dosage MeSH
- Anti-Bacterial Agents * therapeutic use adverse effects administration & dosage MeSH
- Bismuth * therapeutic use administration & dosage MeSH
- Adult MeSH
- Helicobacter pylori * drug effects MeSH
- Helicobacter Infections * drug therapy MeSH
- Proton Pump Inhibitors * therapeutic use administration & dosage adverse effects MeSH
- Clarithromycin therapeutic use administration & dosage MeSH
- Drug Therapy, Combination * MeSH
- Middle Aged MeSH
- Humans MeSH
- Metronidazole therapeutic use administration & dosage MeSH
- Registries * MeSH
- Aged MeSH
- Tetracycline therapeutic use administration & dosage MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Observational Study MeSH
- Geographicals
- Europe MeSH
- Names of Substances
- Amoxicillin MeSH
- Anti-Bacterial Agents * MeSH
- Bismuth * MeSH
- Proton Pump Inhibitors * MeSH
- Clarithromycin MeSH
- Metronidazole MeSH
- Tetracycline MeSH
BACKGROUND: Bismuth quadruple therapies (BQTs) including bismuth, a proton pump inhibitor (PPI) and two antibiotics have been shown to be highly effective for treating Helicobacter pylori infection even in areas of high bacterial antibiotic resistance. OBJECTIVE: To describe the time trends of use, effectiveness and safety of BQT in Europe using the European Registry on Helicobacter pylori Management (Hp-EuReg). DESIGN: Patients registered in the Hp-EuReg from 2013 to 2021 who had received BQT were included. The regimens prescribed, the number of eradication attempts, effectiveness, adherence and safety were analysed. The effectiveness was assessed by modified intention to treat (mITT). Time-trend and multivariate analyses were performed to determine variables that predicted treatment success. RESULTS: Of the 49 690 patients included in the Hp-EuReg, 15 582 (31%) had received BQT. BQT use increased from 8.6% of all treatments in 2013 to 39% in 2021. Single-capsule BQT-containing bismuth, metronidazole and tetracycline-plus a PPI (single-capsule BQT, ScBQT) was the most frequent treatment mode (43%). Schemes that obtained an effectiveness above 90% were the 10-day ScBQT and 14-day BQT using tetracycline plus metronidazole, or amoxicillin plus either clarithromycin or metronidazole. Only ScBQT achieved above 90% cure rates in all the geographical areas studied. Using the ScBQT scheme, adherence, the use of standard or high-dose PPIs, 14-day prescriptions and the use of BQT as first-line treatment were significantly associated with higher mITT effectiveness. CONCLUSION: The use of BQT increased notably in Europe over the study period. A 10-day ScBQT was the scheme that most consistently achieved optimal effectiveness. TRIAL REGISTRATION NUMBER: NCT02328131.
1st Clinical Medical Centre Kovrov Russian Federation
Center for Research in Health Technologies and Information Systems Porto Portugal
Department of Digestive Disorders Aberdeen Royal Infirmary Aberdeen UK
Department of Gastroenterology Centro Hospitalar do Porto Porto Portugal
Department of Gastroenterology Chelyabinsk Regional Clinical Hospital Chelyabinsk Russian Federation
Department of Gastroenterology DC Rogaska Rogaska Slatina Slovenia
Department of Gastroenterology Digestive Diseases Centre Riga Latvia
Department of Gastroenterology Hacettepe University Ankara Turkey
Department of Gastroenterology HC International Clinic Ankara Turkey
Department of Gastroenterology Hospital Clínic de Barcelona Barcelona Spain
Department of Gastroenterology Hospital Clínico Universitario Lozano Blesa Zaragoza Spain
Department of Gastroenterology Hospital General de Tomelloso Tomelloso Spain
Department of Gastroenterology Hospital Santos Reyes Aranda de Duero Spain
Department of Gastroenterology Hospital Universitario Costa del Sol Marbella Spain
Department of Gastroenterology Hospital Universitario de Valme Sevilla Spain
Department of Gastroenterology Hospital Universitario La Moraleja Madrid Spain
Department of Gastroenterology Kantonsspital Aarau Aarau Switzerland
Department of Gastroenterology Lithuanian University of Health Sciences Kaunas Lithuania
Department of Gastroenterology Molinette SGAS Hospital Turin Italy
Department of Gastroenterology Østfold Hospital Trust Grålum Norway
Department of Gastroenterology Pomeranian Medical University Szczecin Poland
Department of Gastroenterology Rabin Medical Center Tel Aviv Israel
Department of Gastroenterology University Hospital of Split Split Croatia
Department of Gastroenterology University of Oviedo Oviedo Spain
Department of Surgery Transplantation and Gastroenterology Semmelweis University Budapest Hungary
Dr Miriam and Sheldon G Adelson School of Medicine Ariel University Ari'el Israel
Faculty of Health Sciences Trinity College Dublin Dublin Ireland
Faculty of Medicine Universidad Francisco de Vitoria Madrid Spain
Gastrointestinal Oncology Endoscopy and Surgery Manresa Barcelona Spain
Institut d'Investigacions Biomèdiques August Pi i Sunyer Barcelona Spain
Institute of Clinical and Preventive Medicine University of Latvia Riga Latvia
Instituto De Ciências Biomédicas de Abel Salazar Universidade do Porto Porto Portugal
Instituto de Investigación Sanitaria de Aragón Zaragoza Spain
Redes de Investigación Cooperativa Orientada a Resultados en Salud Marbella Spain
School of Medicine Trinity College Dublin Dublin Ireland
Tel Aviv University Tel Aviv Israel
The Centre for Digestive Diseases Endoklinika Szczecin Poland
Universidad Autónoma de Madrid Madrid Spain
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ClinicalTrials.gov
NCT02328131
