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20 záznamů v Medvik Filtry

Článek online

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)

Olmedo, Llum
Autor Olmedo, Llum ORCID Medicina, Programa de Doctorado en Ciencias de la Salud, Universitat Internacional de Catalunya, Sant Cugat del Valles, Barcelona, Spain ABS Manresa 3, Althaia Xarxa Assistencial Universitària de Manresa. Institut de Recerca i Innovació en Ciències de la Vida i de la Salut de la Catalunya Central (IRIS-CC), Manresa, Barcelona, Spain Gastrointestinal Oncology Endoscopy and Surgery (GOES) research group, Althaia Xarxa Assistencial Universitària de Manresa. Institut de Recerca i Innovació en Ciències de la Vida i de la Salut de la Catalunya Central (IRIS-CC), Manresa, Barcelona, Spain
Calvet, Xavier
Autor Calvet, Xavier ORCID Servei d'Aparell Digestiu, Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA). Universitat Autònoma de Barcelona, Sabadell, Spain xcalvet@tauli.cat Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
Gené, Emili
Autor Gené, Emili ORCID Medicina, Programa de Doctorado en Ciencias de la Salud, Universitat Internacional de Catalunya, Sant Cugat del Valles, Barcelona, Spain Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain Servei d'Urgències, Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA). Universitat Autònoma de Barcelona, Sabadell, Spain
Bordin, Dmitry S
Autor Bordin, Dmitry S ORCID Department of Pancreatic, Biliary and Upper Digestive Tract Disorders, AS Loginov Moscow Clinical Scientific Center, Moscow, Russian Federation Department of Propaedeutic of Internal Diseases and Gastroenterology, Russian University of Medicine, Moscow, Russian Federation Department of Outpatient Therapy and Family Medicine, Tver State Medical University, Tver, Russian Federation
Voynovan, Irina
Autor Voynovan, Irina Department of Gastroenterology, AS Loginov Moscow Clinical Scientific Center, Moscow, Russian Federation
Castro-Fernandez, M
Autor Castro-Fernandez, M Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain Department of Gastroenterology, Hospital Universitario de Valme, Sevilla, Spain
Pabón-Carrasco, Manuel
Autor Pabón-Carrasco, Manuel ORCID Department of Gastroenterology, Hospital Universitario de Valme, Sevilla, Spain
Keco-Huerga, Alma
Autor Keco-Huerga, Alma Department of Gastroenterology, Hospital Universitario de Valme, Sevilla, Spain
Perez-Aisa, Ángeles
Autor Perez-Aisa, Ángeles ORCID Department of Gastroenterology, Hospital Universitario Costa del Sol, Marbella, Spain Redes de Investigación Cooperativa Orientada a Resultados en Salud (RICORS), Marbella, Spain
Lucendo, Alfredo J
Autor Lucendo, Alfredo J ORCID Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Spain Department of Gastroenterology, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain Department of Gastroenterology, Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Tomelloso, Spain

Gut. 2024 ; 74 (1) : 15-25. [pub] 20241210

ISSN 1468-3288
Medvik
Zdroj

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.

Článek online

Role of compliance in Helicobacter pylori eradication treatment: Results of the European Registry on H. pylori management

United European gastroenterology journal. 2024 ; 12 (6) : 691-704. [pub] 20240429

United European Gastroenterol J
ISSN 2050-6414
Medvik
Zdroj

BACKGROUND: Adherence to Helicobacter pylori (H. pylori) eradication treatment is a cornerstone for achieving adequate treatment efficacy. OBJECTIVE: To determine which factors influence compliance with treatment. METHODS: A systematic prospective non-interventional registry (Hp-EuReg) of the clinical practice of European gastroenterologists. Compliance was considered adequate if ≥90% drug intake. Data were collected until September 2021 using the AEG-REDCap e-CRF and were subjected to quality control. Modified intention-to-treat analyses were performed. Multivariate analysis carried out the factors associated with the effectiveness of treatment and compliance. RESULTS: Compliance was inadequate in 646 (1.7%) of 38,698 patients. The non-compliance rate was higher in patients prescribed longer regimens (10-, 14-days) and rescue treatments, patients with uninvestigated dyspepsia/functional dyspepsia, and patients reporting adverse effects. Prevalence of non-adherence was lower for first-line treatment than for rescue treatment (1.5% vs. 2.2%; p < 0.001). Differences in non-adherence in the three most frequent first-line treatments were shown: 1.1% with proton pump inhibitor + clarithromycin + amoxicillin; 2.3% with proton pump inhibitor clarithromycin amoxicillin metronidazole; and 1.8% with bismuth quadruple therapy. These treatments were significantly more effective in compliant than in non-compliant patients: 86% versus 44%, 90% versus 71%, and 93% versus 64%, respectively (p < 0.001). In the multivariate analysis, the variable most significantly associated with higher effectiveness was adequate compliance (odds ratio, 6.3 [95%CI, 5.2-7.7]; p < 0.001). CONCLUSIONS: Compliance with Helicobacter pylori eradication treatment is very good. Factors associated with poor compliance include uninvestigated/functional dyspepsia, rescue-treatment, prolonged treatment regimens, the presence of adverse events, and the use of non-bismuth sequential and concomitant treatment. Adequate treatment compliance was the variable most closely associated with successful eradication.

Článek online

Léčba infekce Helicobacter pylori rezistentní na standardní léčbu : současný stav a perspektivy
[Therapy of Helicobacter pylori infection resistant to the standard treatment : present situation and outlook]

Fixa, Bohumil, 1929-2014
Autor Autorita
Vaňásek, Tomáš, 1963-
Autor Autorita

Česká a slovenská gastroenterologie a hepatologie. 2009 ; 63 (2) : 65-73.

ISSN 1213-323X
Medvik
Zdroj

Metodou první volby (první linie) v léčbě infekce Helicobacter pylori zůstávají standardní trojkombinace inhibitorů protonové pumpy (PPI) s amoxicilinem nebo metronidazolem a klaritromycinem. Jejich úspěšnost se postupně snižuje a v některých oblastech klesá pod 80 %. Je-li neúspěšná trojkombinace s amoxicilinem, je vhodné použít kombinaci s metronidazolem a naopak (metody 2. linie). V současnosti je také jako metoda první volby zaváděna tzv. sekvenční léčba. Jako perspektivní léčba rezistentní infekce Helicobacter pylori se jeví zejména nové kombinace s levofloxacinem, v indikovaných případech případně s rifabutinem nebo furazolidonem (metody 3. až 4. linie). Selžou-li všechny uvedené způsoby, bývá doporučovaná tradiční čtyřkombinace (inhibitory protonové pumpy, amoxicillin nebo metronidazol, klaritromycin a koloidní bizmut subcitrát). Jsou uvedeny výhody a nevýhody různých kombinací.

Methods of the 1st line therapy of Helicobacter pylori infection have been based mainly on several combinations of triple therapy (proton pump inhibitors, amoxicillin or metronidazole and clarithromycin). In recent years, the eff ectiveness of this therapy is declining and in some areas falling under 80 %. When a triple combination with amoxicillin is ineff ective, an alternative therapy with metronidazole instead of amoxicillin is recommended (the 2nd line therapy), and vice versa. Recently, of the first line therapies, a so-called sequential therapy has been introduced. As a prospective therapy against a resistant infection of Helicobacter pylori seems to be new combinations with levofloxacine, in indicated cases eventually combinations with rifabutin or furazolidone (methods of the 3rd or 4th line therapy). When all attempts fail, the traditional quadruple therapy (proton pump inhibitors, amoxicillin or metronidazole, clarithromycin and colloidal bismuth subcitrate) are recommended. Advantages and disadvantages of various treatments are discussed.