Role of proton pump inhibitors dosage and duration in Helicobacter pylori eradication treatment: Results from the European Registry on H. pylori management.

Autor: Pabón-Carrasco M; Department of Gastroenterology, Hospital de Valme, Sevilla, Spain., Keco-Huerga A; Department of Gastroenterology, Hospital de Valme, Sevilla, Spain., Castro-Fernández M; Department of Gastroenterology, Hospital de Valme, Sevilla, Spain., Saracino IM; IRCCS AOU di Bologna, Bologna, Italy., Fiorini G; IRCCS AOU di Bologna, Bologna, Italy., Vaira D; IRCCS AOU di Bologna, Bologna, Italy., Pérez-Aísa Á; Agencia Sanitaria Costa del Sol, Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Marbella, Spain., Tepes B; Department of Gastroenterology, AM DC Rogaska, Rogaska Slatina, Slovenia., Jonaitis L; Institute for Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania.; Department of Gastroenterology, Lithuanian University of Health Sciences, Kaunas, Lithuania., Voynovan I; Department of Gastroenterology, A.S. Loginov Moscow Clinical Scientific Center, Moscow, Russia., Lucendo AJ; Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Spain., Lanas Á; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain., Martínez-Domínguez SJ; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain., Almajano EA; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain., Rodrigo L; Gastroenterology Unit, Hospital Universitario Central de Asturias, Oviedo, Spain., Vologzanina L; Department of Gastroenterology, Gastrocentr, Perm, Russia., Brglez Jurecic N; Department of Gastroenterology, Interni Oddelek, Diagnostic Centre, Bled, Slovenia., Denkovski M; Department of Gastroenterology, Interni Oddelek, Diagnostic Centre, Bled, Slovenia., Bujanda L; Hospital Donostia, Instituto Biodonostia, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Universidad del País Vasco (UPV/EHU), San Sebastián, Spain., Abdulkhakov RA; Department of Hospital Medicine, Kazan State Medical University, Kazan, Tatarstan, Russia., Huguet JM; Patología Digestiva, Hospital General Universitario de Valencia, Valencia, Spain., Fernández-Salazar L; Gastroenterology Department, Hospital Clínico Universitario de Valladolid (SACYL), Valladolid, Spain., Alcaide N; Gastroenterology Department, Hospital Clínico Universitario de Valladolid (SACYL), Valladolid, Spain., Velayos B; Gastroenterology Department, Hospital Clínico Universitario de Valladolid (SACYL), Valladolid, Spain., Silkanovna Sarsenbaeva A; Department of Gastroenterology, Chelyabinsk Regional Clinical Hospital, Chelyabinsk, Russia., Zaytsev O; Gastroenterology Unit, First Clinical Medical Center Kovrov, Kovrov, Russia., Ilchishina T; Gastroenterology Unit, SM-Clinic, Saint-Petersburg, Russia., Barrio J; Unidad de Gastroenterología, Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León (SACYL), Valladolid, Spain., Bakulin I; I.I. Mechnikov North-Western State Medical University, Saint Petersburg, Russia., Perona M; Gastroenterology Unit, Hospital Quiron Marbella, Marbella, Spain., Alekseenko S; Far Eastern State Medical University, Khabarovsk, Russia., Romano M; Gastroenterology and Endoscopy Unit, Dipartimento di Medicina di Precisione, Università Vanvitelli, Napoli, Italy., Gravina AG; Gastroenterology and Endoscopy Unit, Dipartimento di Medicina di Precisione, Università Vanvitelli, Napoli, Italy., Núñez Ó; Gastroenterology Unit, Hospital Universitario La Moraleja, Madrid, Spain., Gómez Rodríguez BJ; Gastroenterology Department, Hospital Virgen de la Macarena, Sevilla, Spain., Ledro-Cano D; Gastroenterology Department, Hospital Virgen de la Macarena, Sevilla, Spain., Pellicano R; Unit of Gastroenterology, Molinette-SGAS Hospital, Turin, Italy., Bogomolov P; Universal Clinic Private Medical Center, Moscow, Russia., Domínguez-Cajal M; Unidad de Gastroenterología y Hepatología, Hospital Universitario San Jorge, Huesca, Spain., Almela P; Servicio de Medicina Digestiva, Hospital General Universitario de Castellón, Castellón, Spain.; Ciencias de la Salud (Medicina), Universidad CEU Cardenal Herrera, Castellón, Spain., Gomez-Camarero J; Gastroenterology Department, Hospital Universitario de Burgos, Burgos, Spain., Bordin DS; Department of Pancreatic, Biliary and Upper Digestive Tract Disorders, A. S. Loginov Moscow Clinical Scientific Center, Moscow, Russia.; Department of Propaedeutic of Internal Diseases and Gastroenterology, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia.; Department of Outpatient Therapy and Family Medicine, Tver State Medical University, Tver, Russia., Gasbarrini A; Medicina Interna e Gastroenterologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy., Kupčinskas J; Institute for Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania.; Department of Gastroenterology, Lithuanian University of Health Sciences, Kaunas, Lithuania., Cano-Català A; GOES Research Group, Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Spain., Moreira L; Department of Gastroenterology, Hospital Clínic Barcelona, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), University of Barcelona, Barcelona, Spain., Nyssen OP; Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Universidad Autónoma de Madrid (UAM), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain., Mégraud F; INSERM U1312, Université de Bordeaux, Bordeaux, France., O'Morain C; Faculty of Health Sciences, Trinity College Dublin, Dublin, Ireland., Gisbert JP; Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Universidad Autónoma de Madrid (UAM), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain.
Jazyk: angličtina
Zdroj: United European gastroenterology journal [United European Gastroenterol J] 2024 Feb; Vol. 12 (1), pp. 122-138. Date of Electronic Publication: 2023 Dec 04.
DOI: 10.1002/ueg2.12476
Abstrakt: Background: Management of Helicobacter pylori (H. pylori) infection requires co-treatment with proton pump inhibitors (PPIs) and the use of antibiotics to achieve successful eradication.
Aim: To evaluate the role of dosage of PPIs and the duration of therapy in the effectiveness of H. pylori eradication treatments based on the 'European Registry on Helicobacter pylori management' (Hp-EuReg).
Methods: Hp-EuReg is a multicentre, prospective, non-interventionist, international registry on the routine clinical practice of H. pylori management by European gastroenterologists. All infected adult patients were systematically registered from 2013 to 2022.
Results: Overall, 36,579 patients from five countries with more than 1000 patients were analysed. Optimal (≥90%) first-line-modified intention-to-treat effectiveness was achieved with the following treatments: (1) 14-day therapies with clarithromycin-amoxicillin-bismuth and metronidazole-tetracycline-bismuth, both independently of the PPI dose prescribed; (2) All 10-day (except 10-day standard triple therapy) and 14-day therapies with high-dose PPIs; and (3) 10-day quadruple therapies with clarithromycin-amoxicillin-bismuth, metronidazole-tetracycline-bismuth, and clarithromycin-amoxicillin-metronidazole (sequential), all with standard-dose PPIs. In first-line treatment, optimal effectiveness was obtained with high-dose PPIs in all 14-day treatments, in 10- and 14-day bismuth quadruple therapies and in 10-day sequential with standard-dose PPIs. Optimal second-line effectiveness was achieved with (1) metronidazole-tetracycline-bismuth quadruple therapy for 14- and 10 days with standard and high-dose PPIs, respectively; and (2) levofloxacin-amoxicillin triple therapy for 14 days with high-dose PPIs. None of the 7-day therapies in both treatment lines achieved optimal effectiveness.
Conclusions: We recommend, in first-line treatment, the use of high-dose PPIs in 14-day triple therapy and in 10-or 14-day quadruple concomitant therapy in first-line treatment, while standard-dose PPIs would be sufficient in 10-day bismuth quadruple therapies. On the other hand, in second-line treatment, high-dose PPIs would be more beneficial in 14-day triple therapy with levofloxacin and amoxicillin or in 10-day bismuth quadruple therapy either as a three-in-one single capsule or in the traditional scheme.
(© 2023 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC. on behalf of United European Gastroenterology.)
Databáze: MEDLINE