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Huguet JM, Ferrer-Barceló L, Suárez P, Barcelo-Cerda S, Sempere J, Saracino IM, Fiorini G, Vaira D, Pérez-Aísa Á, Jonaitis L, Tepes B, Castro-Fernandez M, Pabón-Carrasco M, Keco-Huerga A, Voynovan I, Lucendo AJ, Lanas Á, Martínez-Domínguez SJ, Alfaro Almajano E, Rodrigo L, Vologzanina L, Bordin DS, Gasbarrini A, Babayeva G, Lerang F, Leja M, Kupčinskas J, Rokkas T, Marcos-Pinto R, Meštrović A, Gridnyev O, Phull PS, Smith SM, Boltin D, Buzás GM, Kral J, Şimşek H, Matysiak-Budnik T, Milivojevic V, Marlicz W, Venerito M, Boyanova L, Doulberis M, Capelle LG, Cano-Català A, Moreira L, Nyssen OP, Mégraud F, O'Morain C, Gisbert JP. Role of compliance in Helicobacter pylori eradication treatment: Results of the European Registry on H. pylori management. United European Gastroenterol J 2024. [PMID: 38685613 DOI: 10.1002/ueg2.12569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 03/04/2024] [Indexed: 05/02/2024] Open
Abstract
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.
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Affiliation(s)
- Jose M Huguet
- Department of Gastroenterology, Hospital General Universitario de Valencia, Valencia, Spain
| | - Luis Ferrer-Barceló
- Department of Gastroenterology, Hospital General Universitario de Valencia, Valencia, Spain
| | - Patrícia Suárez
- Department of Gastroenterology, Hospital General Universitario de Valencia, Valencia, Spain
| | - Susana Barcelo-Cerda
- Department of Applied Statistics and Operational Research, and Quality, Universitat Politècnica de Valencia, Valencia, Spain
| | - Javier Sempere
- Department of Gastroenterology, Hospital General Universitario de Valencia, Valencia, Spain
| | | | - Giulia Fiorini
- IRCCS S. Orsola Polyclinic, University of Bologna, Bologna, Italy
| | - Dino Vaira
- IRCCS S. Orsola Polyclinic, University of Bologna, Bologna, Italy
| | - Ángeles Pérez-Aísa
- Agencia Sanitaria Costa del Sol, Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Marbella, Spain
| | - Laimas Jonaitis
- Department of Gastroenterology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Bojan Tepes
- Department of Gastroenterology, AM DC Rogaska, Rogaska Slatina, Slovenia
| | - M Castro-Fernandez
- Unidad de Aparato Digestivo, Hospital Universitario de Valme, Sevilla, Spain
| | | | - Alma Keco-Huerga
- Unidad de Aparato Digestivo, Hospital Universitario de Valme, Sevilla, Spain
| | - Irina Voynovan
- Department of Gastroenterology, A.S. Loginov Moscow Clinical Scientific Center, Moscow, Russia
| | - Alfredo J Lucendo
- Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Spain
- CIBER de enfermedades Hepáticas y Digestiva (CIBERehd), Madrid, Spain
- Instituto de Investigación Sanitaria La Princesa, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Tomelloso, Spain
| | - Ángel Lanas
- Servicio de Aparato Digestivo, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
- CIBERehd, Zaragoza, Spain
| | - Samuel J Martínez-Domínguez
- Servicio de Aparato Digestivo, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
- CIBERehd, Zaragoza, Spain
| | - Enrique Alfaro Almajano
- Servicio de Aparato Digestivo, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
- CIBERehd, Zaragoza, Spain
| | - Luis Rodrigo
- Department of Gastroenterology, University of Oviedo, Oviedo, Spain
| | | | - Dmitry S Bordin
- 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
| | - Antonio Gasbarrini
- Medicina interna e Gastroenterologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
| | - Gülüstan Babayeva
- Department of Therapy, Azerbaijan State Advanced Training Institute for Doctors Named After Aziz Aliyev, Baku, Azerbaijan
- Memorial Clinic, Baku, Azerbaijan
| | - Frode Lerang
- Department of Gastroenterology, Østfold Hospital Trust, Grålum, Norway
| | - Mārcis Leja
- Department of Gastroenterology, Digestive Diseases Centre, Riga, Latvia
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia
| | - Juozas Kupčinskas
- Department of Gastroenterology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Theodore Rokkas
- Department of Gastroenterology, Henry Dunant Hospital, Athens, Greece
| | - Ricardo Marcos-Pinto
- Gastroenterology Department, Centro Hospitalar do Porto, Instituto De Ciências Biomédicas de Abel Salazar, Universidade do Porto, Porto, Portugal
- Cintesis, Center for Research in Health Technologies and Information Systems (CINTESIS), Porto, Portugal
| | - Antonio Meštrović
- Department of Gastroenterology, University Hospital of Split, University of Split School of Medicine, Split, Croatia
| | - Oleksiy Gridnyev
- Division for the Study of the Digestive Diseases and its Comorbidity with Noncommunicable Diseases, Government Institution L.T.Malaya Therapy National Institute of the National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine
| | - Perminder S Phull
- Department of Digestive Disorders, Aberdeen Royal Infirmary, Aberdeen, UK
| | - Sinead M Smith
- Faculty of Health Sciences, Trinity College Dublin, Dublin, Ireland
| | - Doron Boltin
- Division of Gastroenterology, Rabin Medical Center, Petah Tikva, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - György Miklós Buzás
- Department of Gastroenterology, Ferencváros Health Centre, Budapest, Hungary
| | - Jan Kral
- Hepatogastroenterology Department, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
- Department of Internal Medicine, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Halis Şimşek
- Division of Gastroenterology and Hepatology, Hacettepe University School of Medicine, Ankara, Turkey
| | | | - Vladimir Milivojevic
- Department of Gastroenterology, Clinical Center of Serbia, University of Belgrade School of Medicine, Belgrade, Serbia
| | - Wojciech Marlicz
- Department of Gastroenterology, Pomeranian Medical University in Szczecin, Szczecin, Poland
- The Centre for Digestive Diseases, Endoklinika, Szczecin, Poland
| | - Marino Venerito
- Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University Hospital, Magdeburg, Germany
| | - Lyudmila Boyanova
- Department of Gastroenterology, Medical Microbiology, Medical University of Sofia, Sofia, Bulgaria
| | - Michael Doulberis
- Medical University Department, Division of Gastroenterology and Hepatology, Kantonsspital Aarau, Aarau, Switzerland
- Gastroklinik, Private Gastroenterological Practice, Horgen, Switzerland
| | - Lisette G Capelle
- Department of Gastroenterology and Hepatology, Meander Medical Center, Amersfoort, Netherlands
| | - Anna Cano-Català
- GOES Research Group, Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Spain
| | - Leticia Moreira
- 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
| | - Olga P Nyssen
- 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
| | | | - Colm O'Morain
- Faculty of Health Sciences, Trinity College Dublin, Dublin, Ireland
| | - Javier P Gisbert
- 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
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Pabón-Carrasco M, Keco-Huerga A, Castro-Fernández M, Saracino IM, Fiorini G, Vaira D, Pérez-Aísa Á, Tepes B, Jonaitis L, Voynovan I, Lucendo AJ, Lanas Á, Martínez-Domínguez SJ, Almajano EA, Rodrigo L, Vologzanina L, Brglez Jurecic N, Denkovski M, Bujanda L, Abdulkhakov RA, Huguet JM, Fernández-Salazar L, Alcaide N, Velayos B, Silkanovna Sarsenbaeva A, Zaytsev O, Ilchishina T, Barrio J, Bakulin I, Perona M, Alekseenko S, Romano M, Gravina AG, Núñez Ó, Gómez Rodríguez BJ, Ledro-Cano D, Pellicano R, Bogomolov P, Domínguez-Cajal M, Almela P, Gomez-Camarero J, Bordin DS, Gasbarrini A, Kupčinskas J, Cano-Català A, Moreira L, Nyssen OP, Mégraud F, O'Morain C, Gisbert JP. Role of proton pump inhibitors dosage and duration in Helicobacter pylori eradication treatment: Results from the European Registry on H. pylori management. United European Gastroenterol J 2024; 12:122-138. [PMID: 38050339 PMCID: PMC10859719 DOI: 10.1002/ueg2.12476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 08/15/2023] [Indexed: 12/06/2023] Open
Abstract
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.
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Affiliation(s)
| | - Alma Keco-Huerga
- Department of Gastroenterology, Hospital de Valme, Sevilla, Spain
| | | | | | | | | | - Ángeles Pérez-Aísa
- Agencia Sanitaria Costa del Sol, Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Marbella, Spain
| | - Bojan Tepes
- Department of Gastroenterology, AM DC Rogaska, Rogaska Slatina, Slovenia
| | - Laimas Jonaitis
- Institute for Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Department of Gastroenterology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Irina Voynovan
- Department of Gastroenterology, A.S. Loginov Moscow Clinical Scientific Center, Moscow, Russia
| | - Alfredo J Lucendo
- Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Spain
| | - Ángel Lanas
- Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | | | | | - Luis Rodrigo
- Gastroenterology Unit, Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | | | - Maja Denkovski
- Department of Gastroenterology, Interni Oddelek, Diagnostic Centre, Bled, Slovenia
| | - Luis Bujanda
- 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
| | - Rustam A Abdulkhakov
- Department of Hospital Medicine, Kazan State Medical University, Kazan, Tatarstan, Russia
| | - Jose M Huguet
- Patología Digestiva, Hospital General Universitario de Valencia, Valencia, Spain
| | - Luis Fernández-Salazar
- Gastroenterology Department, Hospital Clínico Universitario de Valladolid (SACYL), Valladolid, Spain
| | - Noelia Alcaide
- Gastroenterology Department, Hospital Clínico Universitario de Valladolid (SACYL), Valladolid, Spain
| | - Benito Velayos
- Gastroenterology Department, Hospital Clínico Universitario de Valladolid (SACYL), Valladolid, Spain
| | | | - Oleg Zaytsev
- Gastroenterology Unit, First Clinical Medical Center Kovrov, Kovrov, Russia
| | | | - Jesús Barrio
- Unidad de Gastroenterología, Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León (SACYL), Valladolid, Spain
| | - Igor Bakulin
- I.I. Mechnikov North-Western State Medical University, Saint Petersburg, Russia
| | - Monica Perona
- Gastroenterology Unit, Hospital Quiron Marbella, Marbella, Spain
| | | | - Marco Romano
- Gastroenterology and Endoscopy Unit, Dipartimento di Medicina di Precisione, Università Vanvitelli, Napoli, Italy
| | - Antonietta G Gravina
- Gastroenterology and Endoscopy Unit, Dipartimento di Medicina di Precisione, Università Vanvitelli, Napoli, Italy
| | - Óscar Núñez
- Gastroenterology Unit, Hospital Universitario La Moraleja, Madrid, Spain
| | | | - Diego Ledro-Cano
- Gastroenterology Department, Hospital Virgen de la Macarena, Sevilla, Spain
| | | | | | - Manuel Domínguez-Cajal
- Unidad de Gastroenterología y Hepatología, Hospital Universitario San Jorge, Huesca, Spain
| | - Pedro Almela
- Servicio de Medicina Digestiva, Hospital General Universitario de Castellón, Castellón, Spain
- Ciencias de la Salud (Medicina), Universidad CEU Cardenal Herrera, Castellón, Spain
| | | | - Dmitry S Bordin
- 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
| | - Antonio Gasbarrini
- Medicina Interna e Gastroenterologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
| | - Juozas Kupčinskas
- Institute for Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Department of Gastroenterology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Anna Cano-Català
- GOES Research Group, Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Spain
| | - Leticia Moreira
- 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
| | - Olga P Nyssen
- 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
| | | | - Colm O'Morain
- Faculty of Health Sciences, Trinity College Dublin, Dublin, Ireland
| | - Javier P Gisbert
- 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
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3
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Pérez-Aisa Á, Nyssen OP, Keco-Huerga A, Rodrigo L, Lucendo AJ, Gomez-Rodriguez BJ, Ortuño J, Perona M, Huguet JM, Núñez O, Fernandez-Salazar L, Barrio J, Lanas A, Iyo E, Romero PM, Fernández-Bermejo M, Gomez B, Garre A, Gomez-Camarero J, Lamuela LJ, Campillo A, de la Peña-Negro L, Dominguez Cajal M, Bujanda L, Burgos-Santamaría D, Bermejo F, González-Carrera V, Pajares R, Notari PA, Tejedor-Tejada J, Planella M, Jiménez I, Lázaro YA, Cuadrado-Lavín A, Pérez-Martínez I, Amorena E, Gonzalez-Santiago JM, Angueira T, Flores V, Martínez-Domínguez SJ, Pabón-Carrasco M, Velayos B, Algaba A, Ramírez C, Almajano EA, Castro-Fernandez M, Alcaide N, Sanz Segura P, Cano-Català A, García-Morales N, Moreira L, Mégraud F, O'Morain C, Calvet X, Gisbert JP. Bismuth quadruple three-in-one single capsule three times a day increases effectiveness compared with the usual four times a day schedule: results from the European Registry on Helicobacter pylori Management (Hp-EuReg). Gut 2023; 72:2031-2038. [PMID: 37468228 DOI: 10.1136/gutjnl-2022-329259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 06/30/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND The recommended schedule for single capsule bismuth quadruple therapy (scBQT, Pylera) includes a proton pump inhibitor (PPI) two times a day and three scBQT capsules four times a day. Four times a day treatments are inconvenient and reduce adherence. In contrast, adherence improves with three times a day schedules. In clinical practice, many gastroenterologists use four capsule scBQT three times a day. However, the effectiveness and safety of this latter approach remain uncertain. AIM To assess the effectiveness and safety of scBQT administered three times a day in the patients included in the European Registry on Helicobacter pylori Management (Hp-EuReg). METHODS All Spanish adult patients registered in the Asociación Española de Gastroenterología Research Electronic Data Capture (REDCap) database from June 2013 to March 2021 receiving 10-day scBQT were analysed. Modified intention-to-treat effectiveness, adherence and the safety of scBQT given three times a day were calculated and compared with the four times a day schedule. A multivariate analysis was performed to determine independent factors predicting cure of the infection. RESULTS Of the 3712 cases, 2516 (68%) were four times a day and 1196 (32%) three times a day. Mean age was 51 years, 63% were women and 15% had a peptic ulcer. The three times a day schedule showed significantly better overall cure rates than four times a day (1047/1112, 94%; 95% CI 92.7 to 95.6 vs 2207/2423, 91%; 95% CI 89.9 to 92.2, respectively, p=0.002). Adherence and safety data were similar for both regimens. In the multivariate analysis, three times a day dosage, first-line therapy, use of standard or high-dose PPIs and adherence over 90% were significantly associated with cure of the infection. CONCLUSIONS ScBQT prescribed three times a day was more effective than the traditional four times a day schedule. No differences were observed in treatment adherence or safety.
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Affiliation(s)
- Ángeles Pérez-Aisa
- Department of Gastroenterology, Hospital Costal del Sol, Marbella, Spain
- Redes de Investigación Cooperativa orientada a Resultados en Salud (RICORS), Marbella, Spain
| | - Olga P Nyssen
- Department of Gastroenterology, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa, Universidad Autónoma de Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Madrid, Spain
| | - Alma Keco-Huerga
- Department of Gastroenterology, Hospital de Valme, Sevilla, Spain
| | - Luís Rodrigo
- Gastroenterology Service, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Alfredo J Lucendo
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Madrid, Spain
- Department of Gastroenterology, Hospital General Tomelloso, Tomelloso, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Madrid, Spain
- Instituto de Investigación Sanitaria Princesa (IIS-Princesa), UniversidadAutónoma de Madrid (UAM), Madrid, Spain
| | | | - Juan Ortuño
- Department of Gastroenterology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Mónica Perona
- Department of Gastroenterology, Hospital Quiron Marbella, Marbella, Spain
| | - José María Huguet
- Gastroenterology Unit, Consorci Hospital General Universitari de Valencia, Valencia, Spain
| | - Oscar Núñez
- Department of Digestive Diseases, Hospital Universitario Sanitas La Moraleja, Madrid, Spain
| | - Luis Fernandez-Salazar
- Gastroenterologia, Hospital Clínico Universitario Valladolid, Gerencia Regional de Salud (SACYL), Valladolid, Spain
- Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain
| | - Jesus Barrio
- Department of Gastroenterology, Hospital Rio Hortega, Valladolid, Spain
| | - Angel Lanas
- Instituto de Investigación Sanitària de Aragón (IIS Aragorn), Zaragoza, Spain
- Facultad de Medicina. Universidad de Zaragoza, Zaragoza, Spain
- Department of Gastroenterology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Eduardo Iyo
- Digestive Service, Hospital Comarcal de Inca, Inca, Mallorca, Spain
| | - Pilar Mata Romero
- Department of Gastroenterology, Hospital Universitario de Caceres, Cáceres, Spain
| | | | - Barbara Gomez
- Department of Gastroenterology, Hospital de Mataró, Mataro, Spain
| | - Ana Garre
- Department of Gastroenterology, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa, Universidad Autónoma de Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Madrid, Spain
| | | | - Luis Javier Lamuela
- Instituto de Investigación Sanitària de Aragón (IIS Aragorn), Zaragoza, Spain
- Department of Gastroenterology, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Ana Campillo
- Department of Gastroenterology, Hospital Reina Sofía, Tudela, Spain
| | | | | | - Luis Bujanda
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Madrid, Spain
- Department of Gastroenterology, Hospital Donostia, Instituto Biodonostia, Universidad del País Vasco (UPV/EHU), San Sebastian, Spain
| | - Diego Burgos-Santamaría
- Department of Gastroenterology and Hepatology, Hospital Universitario Ramon y Cajal, Madrid, Spain
| | - Fernando Bermejo
- Department of Gastroenterology, Hospital Universitario de Fuenlabrada, Madrid, Spain
- Instituto de Investigación Sanitaria La Paz, Madrid, Spain
| | | | - Ramón Pajares
- Department of Gastroenterology, Hospital Universitario Infanta Sofía, San Sebastian de los Reyes, Madrid, Spain
- Medicine Department, Universidad Europea de Madrid SLU, Madrid, Spain
| | - Pedro Almela Notari
- Digestive Service, Hospital General Universitari de Castelló, Castellon de la Plana, Spain
| | | | - Montserrat Planella
- Department of Gastroenterology, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - Itxaso Jiménez
- Department of Gastroenterology, Hospital Universitario de Galdakao-Usansolo, Galdakao, Spain
| | | | | | - Isabel Pérez-Martínez
- Department of Gastroenterology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Edurne Amorena
- Department of Gastroenterology, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Jesús M Gonzalez-Santiago
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Madrid, Spain
- Department of Gastroenterology, Complejo Universitario de Salamanca. IBSAL, Salamanca, Spain
| | - Teresa Angueira
- Department of Gastroenterology, Hospital General Tomelloso, Tomelloso, Spain
| | - Virginia Flores
- Department of Gastroenterology, Hospital General Universitario Gregorio Marañón - Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Samuel J Martínez-Domínguez
- Instituto de Investigación Sanitària de Aragón (IIS Aragorn), Zaragoza, Spain
- Facultad de Medicina. Universidad de Zaragoza, Zaragoza, Spain
- Department of Gastroenterology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | | | - Benito Velayos
- Gastroenterologia, Hospital Clínico Universitario Valladolid, Gerencia Regional de Salud (SACYL), Valladolid, Spain
- Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain
| | - Alicia Algaba
- Department of Gastroenterology, Hospital Universitario de Fuenlabrada, Madrid, Spain
- Instituto de Investigación Sanitaria La Paz, Madrid, Spain
| | - Consuelo Ramírez
- Department of Gastroenterology, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - Enrique Alfaro Almajano
- Instituto de Investigación Sanitària de Aragón (IIS Aragorn), Zaragoza, Spain
- Facultad de Medicina. Universidad de Zaragoza, Zaragoza, Spain
- Department of Gastroenterology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | | | - Noelia Alcaide
- Gastroenterologia, Hospital Clínico Universitario Valladolid, Gerencia Regional de Salud (SACYL), Valladolid, Spain
- Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain
| | | | - Anna Cano-Català
- Department of Gastroenterology, Research and Innovation Unit, Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Spain
| | - Natalia García-Morales
- Digestive Service, Complexo Hospitalario Universitario de Vigo Sergas, Vigo, Spain
- South Galicia Health Research Institute, Vigo, Spain
| | - Leticia Moreira
- Department of Gastroenterology, Hospital Clínic-UB, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | | | - Colm O'Morain
- Department of Gastroenterology, Faculty of Health Science, Trinity College Dublin, Dublin, Ireland
| | - Xavier Calvet
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Madrid, Spain
- Digestive Diseases Department, Parc Taulí, Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí, Departament de Medicina, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Javier P Gisbert
- Department of Gastroenterology, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa, Universidad Autónoma de Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Madrid, Spain
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Jonaitis P, Nyssen OP, Saracino IM, Fiorini G, Vaira D, Pérez-Aísa Á, Tepes B, Castro-Fernandez M, Pabón-Carrasco M, Keco-Huerga A, Voynovan I, Lucendo AJ, Lanas Á, Martínez-Domínguez SJ, Almajano EA, Rodrigo L, Vologzanina L, Brglez Jurecic N, Denkovski M, Bujanda L, Mahmudov U, Leja M, Lerang F, Babayeva G, Bordin DS, Gasbarrini A, Kupcinskas J, Gridnyev O, Rokkas T, Marcos-Pinto R, Phull PS, Smith SM, Tonkić A, Boltin D, Buzás GM, Šembera Š, Şimşek H, Matysiak-Budnik T, Milivojevic V, Marlicz W, Venerito M, Boyanova L, Doulberis M, Capelle LG, Cano-Català A, Moreira L, Mégraud F, O'Morain C, Gisbert JP, Jonaitis L. Author Correction: Comparison of the management of Helicobacter pylori infection between the older and younger European populations. Sci Rep 2023; 13:18821. [PMID: 37914853 PMCID: PMC10620194 DOI: 10.1038/s41598-023-45888-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023] Open
Affiliation(s)
- Paulius Jonaitis
- Department of Gastroenterology, Lithuanian University of Health Sciences, 50161, Kaunas, Lithuania
| | - Olga P Nyssen
- Gastroenterology Unit, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Universidad Autónoma de Madrid (UAM), Diego de León, 62, 28006, Madrid, Spain.
| | - Ilaria Maria Saracino
- Department of Surgical and Medical Sciences, IRCCS AOUBO, University of Bologna, 40138, Bologna, Italy
| | - Giulia Fiorini
- Department of Surgical and Medical Sciences, IRCCS AOUBO, University of Bologna, 40138, Bologna, Italy
| | - Dino Vaira
- Department of Surgical and Medical Sciences, IRCCS AOUBO, University of Bologna, 40138, Bologna, Italy
| | - Ángeles Pérez-Aísa
- Agencia Sanitaria Costa del Sol, Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), 29651, Marbella, Spain
| | - Bojan Tepes
- Department of Gastroenterology, AM DC Rogaska, 3250, Rogaska Slatina, Slovenia
| | | | | | - Alma Keco-Huerga
- Department of Gastroenterology, Hospital de Valme, 41014, Seville, Spain
| | - Irina Voynovan
- Department of Gastroenterology, A.S. Loginov Moscow Clinical Scientific Center, 111123, Moscow, Russia
| | - Alfredo J Lucendo
- Department of Gastroenterology, Hospital General de Tomelloso, 13700, Tomelloso, Spain
| | - Ángel Lanas
- IIS Aragón y Facultad de Medicina de la Universidad de Zaragoza, 50009, Zaragoza, Spain
| | | | | | - Luis Rodrigo
- Gastroenterology Unit, Hospital Universitario Central de Asturias, 33011, Oviedo, Spain
| | | | - Natasa Brglez Jurecic
- Department of Gastroenterology, Interni Oddelek, Diagnostic Centre, 4260, Bled, Slovenia
| | - Maja Denkovski
- Department of Gastroenterology, Interni Oddelek, Diagnostic Centre, 4260, Bled, Slovenia
| | - Luis Bujanda
- Hospital Donostia, Instituto Biodonostia, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Universidad del País Vasco (UPV/EHU), 20018, San Sebastián, Spain
| | | | - Mārcis Leja
- Department of Gastroenterology, Digestive Diseases Centre Gastro, Institute of Clinical and Preventive Medicine and Faculty of Medicine, University of Latvia, Riga, 1079, Latvia
| | - Frode Lerang
- Department of Gastroenterology, Østfold Hospital Trust, 1714, Grålum, Norway
| | | | - Dmitry S Bordin
- Department of Gastroenterology, A.S. Loginov Moscow Clinical Scientific Center, 111123, Moscow, Russia
- A.I. Yevdokimov Moscow State University of Medicine and Dentistry, 127473, Moscow, Russia
- Tver State Medical University, 170100, Tver, Russia
| | - Antonio Gasbarrini
- Medicina Interna, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - Juozas Kupcinskas
- Department of Gastroenterology, Lithuanian University of Health Sciences, 50161, Kaunas, Lithuania
| | - Oleksiy Gridnyev
- Government Institution "L.T.Malaya Therapy National Institute of the National Academy of Medical Sciences of Ukraine", Kyiv, Ukraine
| | - Theodore Rokkas
- Department of Gastroenterology, Henry Dunant Hospital, 115 26, Athens, Greece
| | - Ricardo Marcos-Pinto
- Department of Gastroenterology, Centro Hospitalar do Porto Institute of Biomedical Sciences Abel Salazar, Centro de Investigação em Tecnologias e Serviços de Saúde, University of Porto, 4050-313, Porto, Portugal
| | - Perminder S Phull
- Department of Gastroenterology, Aberdeen Royal Infirmary, Aberdeen, AB25 2ZN, UK
| | - Sinead M Smith
- Faculty of Health Sciences, Trinity College Dublin, Dublin, D02PN40, Ireland
| | - Ante Tonkić
- Department of Gastroenterology, University Hospital of Split, University of Split School of Medicine, 21000, Split, Croatia
| | - Doron Boltin
- Division of Gastroenterology, Rabin Medical Center, Sackler School of Medicine, Tel Aviv University, 49100, Tel Aviv, Israel
| | - György Miklós Buzás
- Department of Gastroenterology, Ferencváros Health Centre, 1095, Budapest, Hungary
| | - Štěpán Šembera
- 2nd Department of Internal Medicine and Gastroenterology, University Hospital and Charles University, Faculty of Medicine in Hradec Králové, 500 03, Hradec Králové, Czech Republic
| | - Halis Şimşek
- Division of Gastroenterology and Hepatology, Hacettepe University School of Medicine, 06230, Ankara, Turkey
| | - Tamara Matysiak-Budnik
- Department of Gastroenterology, CHRU de Nantes, Hôpital Hôtel Dieu, 44000, Nantes, France
| | - Vladimir Milivojevic
- Department of Gastroenterology, Clinical Center of Serbia, University of Belgrade School of Medicine, 11000, Belgrade, Serbia
| | - Wojciech Marlicz
- Department of Gastroenterology, Pomeranian Medical University, 70-204, Szczecin, Poland
| | - Marino Venerito
- Department of Gastroenterology, Otto-Von-Guericke University, 39120, Magdeburg, Germany
| | - Lyudmila Boyanova
- Department of Gastroenterology, Medical Microbiology, Medical University of Sofia, 1431, Sofia, Bulgaria
| | - Michael Doulberis
- Division of Gastroenterology and Hepatology, Medical University Department, Kantonsspital Aarau, 5001, Aarau, Switzerland
| | - Lisette G Capelle
- Department of Gastroenterology, Meander Medical Center, 3813 TZ, Amersfoort, The Netherlands
| | - Anna Cano-Català
- GOES Research Group, Althaia Xarxa Assistencial Universitària de Manresa, 08243, Manresa, Spain
| | - Leticia Moreira
- 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, 08036, Barcelona, Spain
| | - Francis Mégraud
- INSERM U1312, Université de Bordeaux, 33000, Bordeaux, France
| | - Colm O'Morain
- Faculty of Health Sciences, Trinity College Dublin, Dublin, D02PN40, Ireland
| | - Javier P Gisbert
- Gastroenterology Unit, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Universidad Autónoma de Madrid (UAM), Diego de León, 62, 28006, Madrid, Spain
| | - Laimas Jonaitis
- Department of Gastroenterology, Lithuanian University of Health Sciences, 50161, Kaunas, Lithuania
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5
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Jonaitis P, Nyssen OP, Saracino IM, Fiorini G, Vaira D, Pérez-Aísa Á, Tepes B, Castro-Fernandez M, Pabón-Carrasco M, Keco-Huerga A, Voynovan I, Lucendo AJ, Lanas Á, Martínez-Domínguez SJ, Almajano EA, Rodrigo L, Vologzanina L, Brglez Jurecic N, Denkovski M, Bujanda L, Mahmudov U, Leja M, Lerang F, Babayeva G, Bordin DS, Gasbarrini A, Kupcinskas J, Gridnyev O, Rokkas T, Marcos-Pinto R, Phull PS, Smith SM, Tonkić A, Boltin D, Buzás GM, Šembera Š, Şimşek H, Matysiak-Budnik T, Milivojevic V, Marlicz W, Venerito M, Boyanova L, Doulberis M, Capelle LG, Cano-Català A, Moreira L, Mégraud F, O'Morain C, Gisbert JP, Jonaitis L. Comparison of the management of Helicobacter pylori infection between the older and younger European populations. Sci Rep 2023; 13:17235. [PMID: 37821503 PMCID: PMC10567783 DOI: 10.1038/s41598-023-43287-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 09/21/2023] [Indexed: 10/13/2023] Open
Abstract
The prevalence of Helicobacter pylori remains high in the older population. Specific age-related peculiarities may impact the outcomes of H. pylori treatment. The aim of the study was to evaluate the diagnostics and effectiveness of H. pylori eradication between the younger and older European populations. "European Registry on H. pylori Management (Hp-EuReg)" data from 2013 to 2022 were analyzed. Patients were divided into older (≥ 60 years) and younger (18-59 years) groups. Modified intention-to-treat (mITT) and per-protocol (PP) analysis was performed. 49,461 patients included of which 14,467 (29%) were older-aged. Concomitant medications and penicillin allergy were more frequent among the older patients. Differences between younger and older populations were observed in treatment duration in first-line treatment and in proton pump inhibitors (PPIs) doses in second-line treatment. The overall incidence of adverse events was lower in the older adults group. The overall first-line treatment mITT effectiveness was 88% in younger and 90% in the older patients (p < 0.05). The overall second-line mITT treatment effectiveness was 84% in both groups. The effectiveness of the most frequent first- and second-line triple therapies was suboptimal (< 90%) in both groups. Optimal efficacy (≥ 90%) was achieved by using bismuth and non-bismuth-based quadruple therapies. In conclusion, the approach to the diagnostics and treatment of H. pylori infection did not generally differ between younger and older patients. Main differences were reported in the concurrent medications, allergy to penicillin and adverse events both in first- and second-line treatment. Optimal effectiveness rates were mostly achieved by using bismuth and non-bismuth-based quadruple therapies. No clinically relevant differences in the effectiveness between the age groups were observed.
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Affiliation(s)
- Paulius Jonaitis
- Department of Gastroenterology, Lithuanian University of Health Sciences, 50161, Kaunas, Lithuania
| | - Olga P Nyssen
- Gastroenterology Unit, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Universidad Autónoma de Madrid (UAM), Diego de León, 62, 28006, Madrid, Spain.
| | - Ilaria Maria Saracino
- Department of Surgical and Medical Sciences, IRCCS AOUBO, University of Bologna, 40138, Bologna, Italy
| | - Giulia Fiorini
- Department of Surgical and Medical Sciences, IRCCS AOUBO, University of Bologna, 40138, Bologna, Italy
| | - Dino Vaira
- Department of Surgical and Medical Sciences, IRCCS AOUBO, University of Bologna, 40138, Bologna, Italy
| | - Ángeles Pérez-Aísa
- Agencia Sanitaria Costa del Sol, Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), 29651, Marbella, Spain
| | - Bojan Tepes
- Department of Gastroenterology, AM DC Rogaska, 3250, Rogaska Slatina, Slovenia
| | | | | | - Alma Keco-Huerga
- Department of Gastroenterology, Hospital de Valme, 41014, Seville, Spain
| | - Irina Voynovan
- Department of Gastroenterology, A.S. Loginov Moscow Clinical Scientific Center, 111123, Moscow, Russia
| | - Alfredo J Lucendo
- Department of Gastroenterology, Hospital General de Tomelloso, 13700, Tomelloso, Spain
| | - Ángel Lanas
- IIS Aragón y Facultad de Medicina de la Universidad de Zaragoza, 50009, Zaragoza, Spain
| | | | | | - Luis Rodrigo
- Gastroenterology Unit, Hospital Universitario Central de Asturias, 33011, Oviedo, Spain
| | | | - Natasa Brglez Jurecic
- Department of Gastroenterology, Interni Oddelek, Diagnostic Centre, 4260, Bled, Slovenia
| | - Maja Denkovski
- Department of Gastroenterology, Interni Oddelek, Diagnostic Centre, 4260, Bled, Slovenia
| | - Luis Bujanda
- Hospital Donostia, Instituto Biodonostia, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Universidad del País Vasco (UPV/EHU), 20018, San Sebastián, Spain
| | | | - Mārcis Leja
- Department of Gastroenterology, Digestive Diseases Centre Gastro, Institute of Clinical and Preventive Medicine and Faculty of Medicine, University of Latvia, Riga, 1079, Latvia
| | - Frode Lerang
- Department of Gastroenterology, Østfold Hospital Trust, 1714, Grålum, Norway
| | | | - Dmitry S Bordin
- Department of Gastroenterology, A.S. Loginov Moscow Clinical Scientific Center, 111123, Moscow, Russia
- A.I. Yevdokimov Moscow State University of Medicine and Dentistry, 127473, Moscow, Russia
- Tver State Medical University, 170100, Tver, Russia
| | - Antonio Gasbarrini
- Medicina Interna, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - Juozas Kupcinskas
- Department of Gastroenterology, Lithuanian University of Health Sciences, 50161, Kaunas, Lithuania
| | - Oleksiy Gridnyev
- Government Institution "L.T.Malaya Therapy National Institute of the National Academy of Medical Sciences of Ukraine", Kyiv, Ukraine
| | - Theodore Rokkas
- Department of Gastroenterology, Henry Dunant Hospital, 115 26, Athens, Greece
| | - Ricardo Marcos-Pinto
- Department of Gastroenterology, Centro Hospitalar do Porto Institute of Biomedical Sciences Abel Salazar, Centro de Investigação em Tecnologias e Serviços de Saúde, University of Porto, 4050-313, Porto, Portugal
| | - Perminder S Phull
- Department of Gastroenterology, Aberdeen Royal Infirmary, Aberdeen, AB25 2ZN, UK
| | - Sinead M Smith
- Faculty of Health Sciences, Trinity College Dublin, Dublin, D02PN40, Ireland
| | - Ante Tonkić
- Department of Gastroenterology, University Hospital of Split, University of Split School of Medicine, 21000, Split, Croatia
| | - Doron Boltin
- Division of Gastroenterology, Rabin Medical Center, Sackler School of Medicine, Tel Aviv University, 49100, Tel Aviv, Israel
| | - György Miklós Buzás
- Department of Gastroenterology, Ferencváros Health Centre, 1095, Budapest, Hungary
| | - Štěpán Šembera
- 2nd Department of Internal Medicine and Gastroenterology, University Hospital and Charles University, Faculty of Medicine in Hradec Králové, 500 03, Hradec Králové, Czech Republic
| | - Halis Şimşek
- Division of Gastroenterology and Hepatology, Hacettepe University School of Medicine, 06230, Ankara, Turkey
| | - Tamara Matysiak-Budnik
- Department of Gastroenterology, CHRU de Nantes, Hôpital Hôtel Dieu, 44000, Nantes, France
| | - Vladimir Milivojevic
- Department of Gastroenterology, Clinical Center of Serbia, University of Belgrade School of Medicine, 11000, Belgrade, Serbia
| | - Wojciech Marlicz
- Department of Gastroenterology, Pomeranian Medical University, 70-204, Szczecin, Poland
| | - Marino Venerito
- Department of Gastroenterology, Otto-Von-Guericke University, 39120, Magdeburg, Germany
| | - Lyudmila Boyanova
- Department of Gastroenterology, Medical Microbiology, Medical University of Sofia, 1431, Sofia, Bulgaria
| | - Michael Doulberis
- Division of Gastroenterology and Hepatology, Medical University Department, Kantonsspital Aarau, 5001, Aarau, Switzerland
| | - Lisette G Capelle
- Department of Gastroenterology, Meander Medical Center, 3813 TZ, Amersfoort, The Netherlands
| | - Anna Cano-Català
- GOES Research Group, Althaia Xarxa Assistencial Universitària de Manresa, 08243, Manresa, Spain
| | - Leticia Moreira
- 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, 08036, Barcelona, Spain
| | - Francis Mégraud
- INSERM U1312, Université de Bordeaux, 33000, Bordeaux, France
| | - Colm O'Morain
- Faculty of Health Sciences, Trinity College Dublin, Dublin, D02PN40, Ireland
| | - Javier P Gisbert
- Gastroenterology Unit, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Universidad Autónoma de Madrid (UAM), Diego de León, 62, 28006, Madrid, Spain
| | - Laimas Jonaitis
- Department of Gastroenterology, Lithuanian University of Health Sciences, 50161, Kaunas, Lithuania
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6
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Ariño-Pérez I, Martínez-Domínguez SJ, Alfaro Almajano E, Carrera-Lasfuentes P, Lanas Á. Mistakes in the diagnosis and treatment of Helicobacter pylori infection in daily clinical practice. Helicobacter 2023:e12957. [PMID: 36828666 DOI: 10.1111/hel.12957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/03/2023] [Accepted: 02/09/2023] [Indexed: 02/26/2023]
Abstract
BACKGROUND An adequate diagnostic and therapeutic approach to Helicobacter pylori (H. pylori) infection is the cornerstone to avoid overdiagnosis, overuse of health resources, and increase in antibiotic resistances. The aim of the study was to evaluate the most common errors in clinical practice and the associated risk factors. MATERIALS AND METHODS This is a retrospective observational study including patients with H. pylori infection and no previous treatment belonging to two defined areas of the National Health System in Spain; some of them were enrolled in the European Registry on H. pylori management (Hp-EuReg). Patients were attended by gastroenterologists between 2010 and 2019. According to current guidelines, we evaluated indications for H. pylori investigation, appropriateness of diagnostic test used in dyspeptic patients and discontinuation of surveillance after treatment. RESULTS A total of 1730 patients were included, receiving 2260 eradication regimens. H. pylori infection was investigated in 1.7% cases in absence of a formal indication. Oral endoscopy was incorrectly used in 56% of patients with dyspepsia under 55 years without alarm signs, and urea breath test (UBT) was incorrectly used in 22.4% of patients with dyspepsia ≥55 years or red flags. Levofloxacin containing regimens were used as first-line therapy in 7.5% of non-allergic to penicillin patients. After first-line failure, clarithromycin was repeated in 2.6% of the patients who received second-line therapy. Confirmatory test of H. pylori status was absent in 2.5% cases. Men, patients under 55 years, and patients diagnosed by UBT had a higher risk of not undergoing a confirmatory test. CONCLUSIONS Investigation of H. pylori infection by gastroenterologists is rare in absence of a formal indication; however, endoscopy is commonly used for dyspeptic patients <55 years without red flags and non-invasive tests are still used for dyspeptic patients ≥55 years or presenting alarm signs. Men, patients under 55 years, and patients diagnosed by UBT have an increased risk of being lost to follow-up after eradication treatment.
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Affiliation(s)
- Inés Ariño-Pérez
- Department of Gastroenterology, Obispo Polanco Hospital, Teruel, Spain
| | - Samuel J Martínez-Domínguez
- Department of Gastroenterology, Lozano Blesa University Hospital, Zaragoza, Spain.,Aragón Health Research Institute (IIS Aragón), Zaragoza, Spain.,School of Medicine, University of Zaragoza, Zaragoza, Spain
| | - Enrique Alfaro Almajano
- Department of Gastroenterology, Lozano Blesa University Hospital, Zaragoza, Spain.,Aragón Health Research Institute (IIS Aragón), Zaragoza, Spain
| | - Patricia Carrera-Lasfuentes
- Aragón Health Research Institute (IIS Aragón), Zaragoza, Spain.,CIBER Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain.,Faculty of Health Sciences, Campus Universitario Villanueva de Gállego, Universidad San Jorge, Zaragoza, Spain
| | - Ángel Lanas
- Department of Gastroenterology, Lozano Blesa University Hospital, Zaragoza, Spain.,Aragón Health Research Institute (IIS Aragón), Zaragoza, Spain.,School of Medicine, University of Zaragoza, Zaragoza, Spain.,CIBER Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
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7
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Borao Laguna C, Martínez Domínguez SJ, Saura Blasco N, Hernández Ainsa M, García Mateo S, Velamazán Sandalinas R, Hijos Mallada G, Abad Baroja D, Alfaro Almajano E, Cañamares Orbis P, García Rayado G. Emphysematous pancreatitis: Clinical course and management. Gastroenterol Hepatol 2021; 45 Suppl 1:71-72. [PMID: 33727007 DOI: 10.1016/j.gastrohep.2021.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 02/18/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Cristina Borao Laguna
- Servicio de Aparato Digestivo, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España.
| | | | - Nuria Saura Blasco
- Servicio de Aparato Digestivo, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - María Hernández Ainsa
- Servicio de Aparato Digestivo, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - Sandra García Mateo
- Servicio de Aparato Digestivo, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | | | - Gonzalo Hijos Mallada
- Servicio de Aparato Digestivo, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - Daniel Abad Baroja
- Servicio de Aparato Digestivo, Hospital Universitario Miguel Servet, Zaragoza, España
| | - Enrique Alfaro Almajano
- Servicio de Aparato Digestivo, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | | | - Guillermo García Rayado
- Servicio de Aparato Digestivo, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
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8
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Cañamares Orbís P, Alfaro Almajano E, Laredo de la Torre V, Hijos Mallada G, Abad Baroja D, Velamazán Sandalinas R, García Mateo S, Hernández Ainsa M, Saura Blasco N, Martínez Domínguez SJ, Borao Laguna C. Haematological polyposis: Mantle-cell lymphoma. Gastroenterol Hepatol 2020; 45 Suppl 1:50-52. [PMID: 33259827 DOI: 10.1016/j.gastrohep.2020.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/20/2020] [Accepted: 11/09/2020] [Indexed: 10/22/2022]
Affiliation(s)
- Pablo Cañamares Orbís
- Servicio de Aparato Digestivo, Hospital General Universitario San Jorge, Huesca, España.
| | - Enrique Alfaro Almajano
- Servicio de Aparato Digestivo, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | | | - Gonzalo Hijos Mallada
- Servicio de Aparato Digestivo, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - Daniel Abad Baroja
- Servicio de Aparato Digestivo, Hospital Universitario Miguel Servet, Zaragoza, España
| | | | - Sandra García Mateo
- Servicio de Aparato Digestivo, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - María Hernández Ainsa
- Servicio de Aparato Digestivo, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - Nuria Saura Blasco
- Servicio de Aparato Digestivo, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | | | - Cristina Borao Laguna
- Servicio de Aparato Digestivo, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
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García Mateo S, Velamazán Sandalinas R, Hijos Mallada G, Abad Baroja D, Hernández Ainsa M, Saura Blasco N, Laredo de la Torre V, Alfaro Almajano E, Cañamares Orbis P, Domper Arnal MJ, Sostres Homedes C, Lausín JMB. Ulcerative jejunitis. Serious and uncommon manifestation in the outbreak of coeliac disease. Gastroenterol Hepatol 2020; 44:568-569. [PMID: 33143909 DOI: 10.1016/j.gastrohep.2020.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 06/03/2020] [Accepted: 07/01/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Sandra García Mateo
- Servicio de Aparato Digestivo, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España.
| | | | - Gonzalo Hijos Mallada
- Servicio de Aparato Digestivo, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - Daniel Abad Baroja
- Servicio de Aparato Digestivo, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - María Hernández Ainsa
- Servicio de Aparato Digestivo, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - Nuria Saura Blasco
- Servicio de Aparato Digestivo, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | | | - Enrique Alfaro Almajano
- Servicio de Aparato Digestivo, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | | | - María José Domper Arnal
- Servicio de Aparato Digestivo, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - Carlos Sostres Homedes
- Servicio de Aparato Digestivo, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - José Manuel Blas Lausín
- Servicio de Aparato Digestivo, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
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Alfaro Almajano E, Bengochea Martínez L, Mateos Barrionuevo FJ, Almajano Martinez C. [Synchronous well differentiated ileal neuroendocrine tumour and colonic adenocarcinoma. A case report and a review of the literature]. Rev Esp Patol 2016; 51:14-17. [PMID: 29290315 DOI: 10.1016/j.patol.2016.08.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 07/28/2016] [Accepted: 08/01/2016] [Indexed: 11/26/2022]
Abstract
Synchronous colonic adenocarcinoma and well-differentiated ileal neuroendocrine tumour are infrequent and are usually incidental findings on autopsies or resected surgical specimens. Only rarely are they detected on colonoscopies or during surgery. We present a case of a synchronous caecal adenocarcinoma and well-differentiated ileal neuroendocrine tumour, undetected during colonoscopy, with carcinoid metastasis in one regional lymph node not associated with adenocarcinoma metastasis. A review of the literature shows that the association of non-synchronous second primary malignancies in patients with gastrointestinal carcinoid tumours is reported in more than 50% of cases; however, synchronous tumours are found in only 1-8%. It would appear that well-differentiated ileal neuroendocrine tumour could be a predisposing factor for the development of a second malignancy.
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Affiliation(s)
- Enrique Alfaro Almajano
- Servicio de Aparato Digestivo, Hospital Clínico Universitario «Lozano Blesa», Zaragoza, España.
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