OC.08.5 EFFECTIVENESS OF EMPIRICAL SECOND-LINE H. PYLORI ERADICATION THERAPY IN ITALY: RESULTS FROM THE EUROPEAN REGISTRY ON H. PYLORI MANAGEMENT (HP-EUREG)

2021 ◽  
Vol 53 ◽  
pp. S125
Author(s):  
L. Gatta ◽  
G. Fiorini ◽  
I.M. Saracino ◽  
M. Pavoni ◽  
M. Romano ◽  
...  
Keyword(s):  
Eradication Therapy ◽  
Second Line ◽  
H Pylori ◽  
European Registry

scholarly journals Efficacy of Twice a Day Bismuth Quadruple Therapy for Second-Line Treatment of Helicobacter pylori Infection

2022 ◽  
Vol 12 (1) ◽  
pp. 56
Author(s):  
Jeemyoung Kim ◽  
Eun Jeong Gong ◽  
Myeongsook Seo ◽  
Hyun Il Seo ◽  
Jong Kyu Park ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Eradication Therapy ◽  
Helicobacter Pylori Infection ◽  
Adverse Event Rate ◽  
Line Treatment ◽  
Second Line ◽  
Current Smoking ◽  
Quadruple Therapy ◽  
Standard Triple Therapy ◽  
H Pylori

Bismuth quadruple therapy (BQT) is an effective treatment for Helicobacter pylori infection. However, frequent dosing schedules of BQT regimen often compromise drug adherence and may affect treatment outcomes. This retrospective study aimed to investigate the efficacy of twice-daily BQT compared to that of four times a day therapy. From August 2018 to November 2020, adult patients who failed first-line standard triple therapy and underwent BQT were eligible. Patients were categorized into two groups according to dosing schedule: (i) the BQT group (n = 213) who received standard BQT administered four times a day; and (ii) the BQTb group (n = 141) who received proton pump inhibitor, bismuth 600 mg, metronidazole 500 mg, and tetracycline 1 g twice a day. The eradication rate did not differ between the BQT (92.5%) and the BQTb groups (90.1%) (p = 0.441). Adherence and adverse event rate were similar between the two groups. Multivariate analysis showed that current smoking was associated with eradication failure; however, dosing frequency was not associated with the efficacy of eradication therapy. This study suggested that twice a day BQT is as effective as four times a day therapy for second-line treatment of H. pylori infection.

scholarly journals Efficacy of second-line regimens for Helicobacter pylori eradication treatment: a systemic review and network meta-analysis

2020 ◽  
Vol 7 (1) ◽  
pp. e000472 ◽  
Author(s):  
Yen-Lin Chang ◽  
Yu-Chun Tung ◽  
Yu-Kang Tu ◽  
Hong-Zen Yeh ◽  
Jyh-Chin Yang ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Triple Therapy ◽  
Subgroup Analysis ◽  
Meta Analysis ◽  
Eradication Therapy ◽  
Second Line ◽  
First Line ◽  
Quadruple Therapy ◽  
Clarithromycin Resistance ◽  
H Pylori

BackgroundCurrent guidelines recommend bismuth-containing quadruple therapy (BQT) and quinolone-containing therapy after failure of first-line Helicobacter pylori eradication therapy. However, the optimum regimen of second-line eradication therapy remains elusive. We conducted a network meta-analysis to compare the relative efficacy of 16 second-line H. pylori eradication regimens.MethodsThree major bibliographic databases were reviewed to enrol relevant randomised controlled trials between January 2000 and September 2018. Network meta-analysis was conducted by STATA software and we performed subgroup analysis in countries with high clarithromycin resistance and high levofloxacin resistance, and in patients with documented failure of first-line triple therapy.ResultsFifty-four studies totalling 8752 participants who received 16 regimens were eligible for analysis. Compared with a 7-day BQT, use of probiotic add-on therapy during, before, and after second-line antibiotic regimens, quinolone-based sequential therapy for 10–14 days, quinolone-based bismuth quadruple therapy for 10–14 days, bismuth quadruple therapy for 10–14 days, and quinolone-based triple therapy for 10–14 days were significantly superior to the other regimens. Subgroup analysis of countries with high clarithromycin resistance and high levofloxacin resistance revealed that the ranking of second-line eradication regimens was distributed similarly in each group, as well as in patients with failure of first-line triple therapy.ConclusionWe conducted a detailed comparison of second-line H. pylori regimens according to different antibiotic resistance rates and the results suggest alternative treatment choices with potential benefits beyond those that could be achieved using salvage therapies recommended by guidelines.

The Diagnosis and Therapy of Helicobacter pylori Infection in Hungary: Comparison of Strategies Applied by Family Physicians and Internists

2019 ◽  
Vol 37 (6) ◽  
pp. 434-443
Author(s):  
Bernadett Márkus ◽  
László Herszényi ◽  
Melinda Matyasovszky ◽  
Krisztián Vörös ◽  
Péter Torzsa ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Helicobacter Pylori ◽  
Eradication Therapy ◽  
Family Physicians ◽  
Helicobacter Pylori Infection ◽  
Board Certification ◽  
The Other ◽  
Second Line ◽  
Sources Of Information ◽  
H Pylori

Background Aims: Most patients with Helicobacter pylori infection are consulted for the first time by family physicians. We aimed to survey the adherence to the newest guidelines of the management of H. pylori infection in the primary and secondary care settings in Hungary. Methods: From a total of 793 physicians, 94 trainees in family medicine, 334 family physicians without and 195 with board certification in internal medicine, 87 internists, 78 family paediatricians were invited to take part in the study. Diagnostic and therapeutic attitudes towards H. pylori infection were compared by a voluntary and anonymous questionnaire. Results: Participants test for H. pylori infection in 92.8% of cases with a family history of peptic ulcer or 76.9% of gastric cancer, 68.9% of dyspepsia and 49.9% of non-specific abdominal complaints, before initiation of non-steroidal anti-inflammatory drug (NSAID; 17.3%) and antiplatelet treatment (14.5%), respectively. They confirm the success of eradication therapy in 88.1% mainly by urea breath test. Most of them initiate eradication therapy by themselves and only 22.4% refer their patients to a gastroenterologist. Clarithromycin-based standard triple therapy is the most preferred (62.1%) and only 3.7% choose quadruple combination with bismuth as first-line and 48.1% as second-line therapy. We found significant differences between groups with respect to the physicians’ own infection, localization of practice, and sources of information on H. pylori infection. Internists are more likely to clarify H. pylori status before the initiation of NSAID and antiplatelet therapies, initiate second-line therapies and use bismuth compared to the other groups. Family physicians with board certification in internal medicine are also prone to start eradication therapy and less prone to refer patients to a gastroenterologist. Family paediatricians prefer stool antigen determination, screen family members and prefer gastroenterologist consultation more often, and use bismuth less frequently than the other groups. Family physicians with previous infection check for H. pyloriinfection more frequently before the initiation of NSAID treatment and are more likely to use histology to detect H. pylori. Postgraduate trainings were the most popular source of information. Conclusion: The adherence to the recent recommendations of current guidelines is moderate. There is a need to increase adherence to current recommendations by family physicians and internists.

scholarly journals Evaluation of the Effectiveness of Helicobacter pylori Eradication Regimens in Lithuania during the Years 2013–2020: Data from the European Registry on Helicobacter pylori Management (Hp-EuReg)

Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 642
Author(s):  
Paulius Jonaitis ◽  
Juozas Kupcinskas ◽  
Olga P. Nyssen ◽  
Ignasi Puig ◽  
Javier P. Gisbert ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Triple Therapy ◽  
Diagnostic Methods ◽  
Line Treatment ◽  
Second Line ◽  
First Line ◽  
Intention To Treat ◽  
H Pylori ◽  
Cure Rates ◽  
European Registry

Background and Objectives: The prevalence of H. pylori in Eastern Europe remains quite high; however, there is insufficient data on the eradication regimens and their effectiveness. Therefore, the objective of the study was to evaluate the diagnostic methods and treatment of H. pylori infection as well as their adherence to Maastricht V/Florence consensus during the years 2013–2020 in Lithuania. Materials and Methods: Sub-study of the “European Registry on H. pylori Management” (Hp-EuReg), international multicenter prospective non-interventional registry of the routine clinical practice. Lithuanian data from the years 2013–2020 were analyzed for effectiveness on a modified intention-to-treat (mITT) basis. 2000 adult patients, diagnosed with H. pylori infection, were included. Data were compared to the European Maastricht V guidelines. Results: Triple-therapy was used in 90% of the cases. In 91% of the first-line prescriptions, standard triple therapy (STT) was used. The most common second-line treatment was a combination of PPI, amoxicillin and levofloxacin (PPI+A+L) (47%). The overall effectiveness in 552 cases valid for analysis was 90% by mITT. In first-line treatment, the STT effectiveness was 90% and second-line treatment with PPI+A+L achieved 92% by mITT. Increasing overall H. pylori eradication rates were observed: from 72% in 2013 to more than 90% in 2018–2020, as well as a shift from 7 to 10–14 days treatments duration throughout 2013–2020. Conclusions: In Lithuania, the prescribed eradication regimens for H. pylori were in accordance with the international guidelines but diagnostic methods and treatment duration only partially met Maastricht V/Florence guidelines. The eradication effectiveness was improved progressively during the years 2018–2020, reaching ≥90% cure rates.

Tu1335 European Registry on H. pylori Management (HP-EuReg) in Spain: Interim Analysis in First and Second Line Therapies

2016 ◽  
Vol 150 (4) ◽  
pp. S877 ◽  
Author(s):  
Maria Caldas ◽  
Angeles Perez Aisa ◽  
Manuel Castro-Fernandez ◽  
Luis Bujanda ◽  
Luis Rodrigo ◽  
...  
Keyword(s):  
Interim Analysis ◽  
Second Line ◽  
H Pylori ◽  
European Registry

scholarly journals European Registry on Helicobacter pylori Management: Effectiveness of First and Second-Line Treatment in Spain

Antibiotics ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. 13
Author(s):  
María Caldas ◽  
Ángeles Pérez-Aisa ◽  
Manuel Castro-Fernández ◽  
Luis Bujanda ◽  
Alfredo Lucendo ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Second Line ◽  
Cure Rate ◽  
Management Effectiveness ◽  
First Line ◽  
Intention To Treat ◽  
First Line Therapy ◽  
Line Therapy ◽  
H Pylori ◽  
European Registry

The management of Helicobacter pylori infection has to rely on previous local effectiveness due to the geographical variability of antibiotic resistance. The aim of this study was to evaluate the effectiveness of first and second-line H. pylori treatment in Spain, where the empirical prescription is recommended. A multicentre prospective non-interventional registry of the clinical practice of European gastroenterologists concerning H. pylori infection (Hp-EuReg) was developed, including patients from 2013 until June 2019. Effectiveness was evaluated descriptively and through a multivariate analysis concerning age, gender, presence of ulcer, proton-pump inhibitor (PPI) dose, therapy duration and compliance. Overall, 53 Spanish hospitals were included, and 10,267 patients received a first-line therapy. The best results were obtained with the 10-day bismuth single-capsule therapy (95% cure rate by intention-to-treat) and with both the 14-day bismuth-clarithromycin quadruple (PPI-bismuth-clarithromycin-amoxicillin, 91%) and the 14-day non-bismuth quadruple concomitant (PPI-clarithromycin-amoxicillin-metronidazole, 92%) therapies. Second-line therapies were prescribed to 2448 patients, with most-effective therapies being the triple quinolone (PPI-amoxicillin-levofloxacin/moxifloxacin) and the bismuth-levofloxacin quadruple schemes (PPI-bismuth-levofloxacin-amoxicillin) prescribed for 14 days (92%, 89% and 90% effectiveness, respectively), and the bismuth single-capsule (10 days, 88.5%). Compliance, longer duration and higher acid inhibition were associated with higher effectiveness. “Optimized” H. pylori therapies achieve over 90% success in Spain.

scholarly journals Impact ofLactobacillus reuteriSupplementation on Anti-Helicobacter pyloriLevofloxacin-Based Second-Line Therapy

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Veronica Ojetti ◽  
Giovanni Bruno ◽  
Maria Elena Ainora ◽  
Giovanni Gigante ◽  
Gianluca Rizzo ◽  
...  
Keyword(s):  
Side Effects ◽  
Triple Therapy ◽  
Eradication Rate ◽  
Eradication Therapy ◽  
Second Line ◽  
Probiotic Supplementation ◽  
Validated Questionnaire ◽  
Group 2 ◽  
H Pylori ◽  
Group 1

Introduction.Helicobacter pylorieradication therapy has the potential burden of antibiotic-associated gastrointestinal (GI) side effects. The occurrence of side effects is among the major drawbacks of such regimens. GI manifestations may be related to alterations in the intestinal microflora. Probiotics can prevent or reduce antibiotic-associated side effects and have an inhibitory effect onH. pylori.Methods. To define the efficacy ofLactobacillus reuterisupplementation inH. pylorieradication and in preventing GI-associated side effects during a second-line levofloxacin triple therapy. 90H. pylori-positive patients receive for 7 days a second-line triple therapy with esomeprazole, levofloxacin, and amoxicillin withL. reuterifor 14 days (group 1) and without probiotic supplementation (group 2). Each subject received a validated questionnaire to record symptoms everyday for 4 weeks from the start of therapy.H. pyloristatus and side effects were assessed 6 weeks after treatment.Results. The eradication rate was significantly influenced by probiotic supplementation withL. reuteri(group 1: 36/45, 80%; group 2: 28/45 62%;P<0.05). The incidence of nausea and diarrhoea in group 1 was significantly lower than that in group 2.Conclusion. InH. pylori-positive subjectsL. reuterisupplementation increases the eradication rate while reducing the incidence of the most common side effects associated with antibiotic therapy in second-line treatment.

Tu1328 Pan-European Registry on H. pylori Management (HP-EuReg): Interim Analysis of First- and Second-Line Treatments

2016 ◽  
Vol 150 (4) ◽  
pp. S875-S876 ◽  
Author(s):  
Adrian G. McNicholl ◽  
Bojan Tepes ◽  
Antonio Gasbarrini ◽  
Angeles Perez Aisa ◽  
D Vaira ◽  
...  
Keyword(s):  
Interim Analysis ◽  
Second Line ◽  
H Pylori ◽  
European Registry
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