György Miklós Buzás1, Olga P Nyssen2, Francis Mégraud3, Colm O'Morain4, Javier P Gisbert2. 1. Gasztroenterológia, Ferencvárosi Egészségügyi Szolgáltató Kft. Budapest, Mester utca 45., 1095. 2. Gastroenterology Unit, Hospital Universitario de la Princesa (IIS-IP), Centro de Investigación Biomédica en Red de Enfermadades Hepáticas y Digestivas (CIBEREHD) Madrid, Spanyolország. 3. Laboratoire de Bactériologie, Hôpital Pellegrin Bordeaux, Franciaország. 4. Department of Clinical Medicine, Trinity College Dublin Dublin, Írország.
Abstract
Introduction: The Pan-European Registry on Helicobacter pylori management was conceived in 2013 to monitor eradication practices in Europe for 10 years. Aim: To assess the efficacy of different eradication regimens in a single outpatient clinic of gastroenterology. Method: Between 2013 and 2019, 247 patients were registered in a prospective non-interventional study. The infection was diagnosed either by endoscopy, histology, rapid urease test or 13C-urea breath test. As first-line treatment, the patients received either a 7-day triple regimen (any of PPI + amoxicillin + clarithromycin or tinidazole), 10-day modified sequential treatment (PPI + amoxicillin for 5 days + tinidazole and levofloxacin for 5 days), 10-day quadruple concomitant treatment (PPI + amoxicillin + tetracycline or doxycycline + metronidazole or tinidazole) or bismuth-based quadruple treatment. Bismuth or non-bismuth based quadruple or alternative regimens were given as second- or third-line treatment. Results: The eradication rates on per protocol basis were: 82.7% (95% confidence interval: 68.1-97.4) (first-line regimens), 85.2% (75.4-94.9) (sequential treatment), 95.1% (89.6-100) (concomitant treatment) and 82.6% (69.7-95.9) (bismuth-based quadruple regimen). Second-line regimens achieved 65.2% (48.2-83.0) and third-line therapy 54.5% (19.4-86.6), respectively. Conclusion: The first-line concomitant regimen was superior to triple and not significantly better than the sequential or bismuth-based treatment. Second- and third-line regimens achieved largely suboptimal results. Orv Hetil. 2019; 160(47): 1856-1863.
Introduction: The Pan-European Registry on Helicobacter pylori management was conceived in 2013 to monitor eradication practices in Europe for 10 years. Aim: To assess the efficacy of different eradication regimens in a single outpatient clinic of gastroenterology. Method: Between 2013 and 2019, 247 patients were registered in a prospective non-interventional study. The infection was diagnosed either by endoscopy, histology, rapid urease test or 13C-urea breath test. As first-line treatment, the patients received either a 7-day triple regimen (any of PPI + amoxicillin + clarithromycin or tinidazole), 10-day modified sequential treatment (PPI + amoxicillin for 5 days + tinidazole and levofloxacin for 5 days), 10-day quadruple concomitant treatment (PPI + amoxicillin + tetracycline or doxycycline + metronidazole or tinidazole) or bismuth-based quadruple treatment. Bismuth or non-bismuth based quadruple or alternative regimens were given as second- or third-line treatment. Results: The eradication rates on per protocol basis were: 82.7% (95% confidence interval: 68.1-97.4) (first-line regimens), 85.2% (75.4-94.9) (sequential treatment), 95.1% (89.6-100) (concomitant treatment) and 82.6% (69.7-95.9) (bismuth-based quadruple regimen). Second-line regimens achieved 65.2% (48.2-83.0) and third-line therapy 54.5% (19.4-86.6), respectively. Conclusion: The first-line concomitant regimen was superior to triple and not significantly better than the sequential or bismuth-based treatment. Second- and third-line regimens achieved largely suboptimal results. Orv Hetil. 2019; 160(47): 1856-1863.
Authors: Paulius Jonaitis; Juozas Kupcinskas; Olga P Nyssen; Ignasi Puig; Javier P Gisbert; Laimas Jonaitis Journal: Medicina (Kaunas) Date: 2021-06-23 Impact factor: 2.430