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Bordin DS, Voynovan IN, Sarsenbaeva AS, Zaytsev OV, Abdulkhakov RA, Bakulina NV, Bakulin IG, Osipenko MF, Livzan MA, Alekseenko SA, Tarasova LV, Tarasova GN, Bogomolov PO, Maev IV, Andreev DN, Abdulkhakov SR, Starostin BD, Bakanova NV, Kononova AG, Kolbasnikov SV, Bueverova EL, Moreira L, Megraud F, O'Morain C, Perez Nyssen O, Gisbert J. [Effectiveness of empirical Helicobacter pylori eradication therapy with furazolidone in Russia: results from the European Registry on Helicobacter pylori Management (Hp-EuReg)]. TERAPEVT ARKH 2023; 95:120-129. [PMID: 37167127 DOI: 10.26442/00403660.2023.02.202107] [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] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 03/29/2023] [Indexed: 05/13/2023]
Abstract
BACKGROUND First-line therapy does not always provide a high level of Helicobacter pylori eradication due to the increase of H. pylori resistance to antibiotics; therefore, it remains necessary to identify the most effective rescue treatments. The purpose of this study was to evaluate the efficacy and safety of empirical H. pylori furazolidone-containing regimens. MATERIALS AND METHODS Adult H. pylori infected patients empirically treated with furazolidone-containing eradication regimens were registered in an international, prospective, multicenter non-intervention European registry on H. pylori management (Hp-EuReg). Data were collected at AEG-REDCap e-CRF from 2013 to 2021 and the quality was reviewed. Modified intention-to-treat (mITT) effectiveness analyses were performed. RESULTS Overall 106 patients received empirical furazolidone-containing therapy in Russia. Furazolidone was prescribed in a sequential scheme along with amoxicillin, clarithromycin and a proton pump inhibitor in 68 (64%) cases, triple regimens were prescribed in 28 (26%) patients and quadruple regimens in 10 (9.4%). Treatment duration of 7 days was assigned to 2 (1.9%) patients, 10-day eradication therapy in case of 80 (75%) and 14 days - in 24 (23%) patients. Furazolidone was mainly used in first- (79%) and second-line (21%) regimens. The methods used to diagnose H. pylori infection were: histology (81%), stool antigen test (64%), 13C-urea breath test (6.6%), and rapid urease test (1.9%). The mITT effectiveness of sequential therapy was 100%; 93% with the triple therapy and 75.5% with quadruple therapy. Compliance was reported in 98% of cases. Adverse events were revealed in 5.7% of patients, mostly nausea (3.8%). No serious adverse events were reported. CONCLUSION Furazolidone containing eradication regimens appear to be an effective and safe empirical therapy in Russia.
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Affiliation(s)
- D S Bordin
- Loginov Moscow Clinical Scientific Center
- Yevdokimov Moscow State University of Medicine and Dentistry
- Tver State Medical University
| | | | | | | | | | - N V Bakulina
- Mechnikov North-Western State Medical University
| | - I G Bakulin
- Mechnikov North-Western State Medical University
| | | | | | | | | | | | - P O Bogomolov
- Yevdokimov Moscow State University of Medicine and Dentistry
- Private Medical Center "Universal"
- Vladimirsky Moscow Regional Clinical Research Institute
| | - I V Maev
- Yevdokimov Moscow State University of Medicine and Dentistry
| | - D N Andreev
- Yevdokimov Moscow State University of Medicine and Dentistry
| | | | | | | | | | | | - E L Bueverova
- Sechenov First Moscow State Medical University (Sechenov University)
| | - L Moreira
- Hospital Clínic de Barcelona
- Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBERehd)
- University of Barcelona
| | | | | | - O Perez Nyssen
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd)
- Universidad Autónoma de Madrid (UAM)
| | - J Gisbert
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd)
- Universidad Autónoma de Madrid (UAM)
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Bordin DS, Voynovan IN, Embutnieks YV, Nyssen OP, Megraud F, O`Morain C, Perez-Gisbert J. European registry on Helicobacter pylori management (Hp-EuReg) as a tool to evaluate and improve clinical practice in Moscow. TERAPEVT ARKH 2020; 92:12-18. [PMID: 32598712 DOI: 10.26442/00403660.2020.02.000567] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Indexed: 12/20/2022]
Abstract
Continuous evaluation of the actual clinical practice of diagnosis and treatment of Helicobacter pylori is crucial in order to provide the best standard of care and to compare health outcomes with expert recommendations.
Aim:to evaluate the effectiveness of the standard triple therapy (amoxicillin, clarithromycin, a proton pump inhibitor) and the standard triple therapy plus bismuth tripotassium dicitrate.
Materials and methods.Observational, prospective, multicenter study, carried out in one single Russian centre A.S. Loginov Moscow Clinical Scientific Center as part of the Hp-EuReg. Patients were included from 2013 to November 2019 by Russian gastroenterologists.
Results.A total of 647 patients were collected and 330 were administered either standard triple therapy ((amoxicillin, clarithromycin, a proton pump inhibitor) or standard triple therapy plus bismuth tripotassium dicitrate. Invasive methods is dominates in the initial diagnosis of H. pylori: the frequency of use of the quick urease test decreased from 50% in 2013 to 31% in 2019. Serology was used in 27.9%. There has been an increase in the use of the13C-urea breath test from 13% in 2013 to 31% in 2019. The histological method (7.5%) and the stool antigen test (3.2%) were used less frequently. For eradication control non-invasive methods are mostly used:13C-UDT (82.7%) and the stool antigen test (14.4%). The effectiveness of standard triple therapy (mITT) was 68% with a 7-day course, 79% with a 10-day course, and 70% with a 14-day course. Combination of bismuth and standard triple therapy eradicates H. pylori (mITT) in 63%, 75% and 89%, respectively.
Conclusion.An improvement in the clinical practice of managing patients with H. pylori infections has been noted. The standard triple therapy in combination with bismuth tripotassium dicitrate, prescribed for 14 days, is more effective.
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Voynovan IN, Embutnieks YV, Mareeva DV, Kolbasnikov SV, Bordin DS. Helicobacter pylori as a risk factor for gastric cancer: the evidence and primary prevention strategy. Alʹm klin med 2019; 47:535-547. [DOI: 10.18786/2072-0505-2019-47-052] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
Russia is a country with a high prevalence of Helicobacter pylori (HP) infection, a high incidence of gastric cancer, and its late diagnosis. HР infection has been recognized as the leading manageable risk factor for gastric cancer. Accurate diagnostic tests must be used to identify and control the effectiveness of HP eradication, and effective schemes must be implemented for HP eradication. The aim of this article was to analyze the latest consensus documents, systematic reviews and meta-analyzes that reflected the role of HP as a risk factor for the development of gastric cancer, as well as measures for the risk reduction. We describe in detail the diagnostic methods for HP infection, provide data on their use in the Russian Federation, and analyze the efficacy of eradication regimens. In all HPinfected individuals, HP leads to chronic inflammation in the gastric mucosa and launches a precancerous cascade (Correa's cascade). The risk of gastric cancer increases with severe atrophy, intestinal metaplasia and dysplasia. Primary prevention of gastric cancer is most effective if the eradication is performed before atrophic gastritis develops. The available consensus documents underline the importance of HP infection identification by accurate diagnostics at this stage of chronic gastritis. In Russia, the primary HP diagnosis is based on histology (37.7%), rapid urease test (29.2%), and serology (29.7%). HP stool antigen test (31.3%), 13C-urea breath test (23.4%) and the histological method (23.3%) are most often used to control eradication. Currently, the first line of eradication therapy is recommended as triple therapy with clarithromycin prescribed for 14 days. It is recommended to use double dose of proton pump inhibitors and bismuth to increase the effectiveness of this scheme. A 14-days triple regimen enhanced by bismuth has been recommended as the first-line therapy in the Russian Federation.
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Affiliation(s)
- I. N. Voynovan
- Loginov Moscow Clinical Scientific Center, Moscow Healthcare Department
| | - Yu. V. Embutnieks
- Loginov Moscow Clinical Scientific Center, Moscow Healthcare Department
| | - D. V. Mareeva
- Loginov Moscow Clinical Scientific Center, Moscow Healthcare Department
| | | | - D. S. Bordin
- Loginov Moscow Clinical Scientific Center, Moscow Healthcare Department;
Tver State Medical University;
A.I. Yevdokimov Moscow State University of
Medicine and Dentistry
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Abstract
Diagnostic tests used to detection Helicobacter pylori are divided into invasive (requiring endoscopy) and non-invasive, direct (bacteriological, histological or molecular detection of the bacterium) and indirect (detection of urease activity of the bacterium or antibodies to it). The choice of the test is determined by the clinical situation, as well as by its availability and cost. The sensitivity of most tests is affected by the use of antisecretory drugs and antibiotics.
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Affiliation(s)
- D S Bordin
- A.S. Loginov Moscow Clinical Research and Practical Center of the Department of Health of Moscow, Moscow, Russia.,Tver State Medical University of the Ministry of Health of the Russian Federation, Tver, Russia
| | - I N Voynovan
- A.S. Loginov Moscow Clinical Research and Practical Center of the Department of Health of Moscow, Moscow, Russia
| | - S V Kolbasnikov
- Tver State Medical University of the Ministry of Health of the Russian Federation, Tver, Russia
| | - Yu V Embutnieks
- A.S. Loginov Moscow Clinical Research and Practical Center of the Department of Health of Moscow, Moscow, Russia
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Bordin DS, Embutnieks YV, Vologzhanina LG, Ilchishina TA, Voynovan IN, Sarsenbaeva AS, Zaitsev OV, Alekseenko SA, Abdulkhakov RA, Dehnich NN, Osipenko MF, Livzan MA, Tsukanov VV, Burkov SG, Bakulina NV, Plotnikova EY, Tarasova LV, Maev IV, Kucheryavyi YA, Baryshnikova NV, Butov MA, Kolbasnikov SV, Pakhomova AL, Zhestkova TV, Baranovsky AY, Abdulhakov SR, Ageeva EA, Lyalyukova EA, Vasyutin AV, Golubev NN, Savilova IV, Morkovkina LV, Kononova AG, Megraud F, O'Morain C, Ramas M, Nyssen OP, McNicholl AG, Gisbert JP. [European registry Helicobacter pylori (Hp-EuReg): how has clinical practice changed in Russia from 2013 to 2018 years]. TERAPEVT ARKH 2019; 91:16-24. [PMID: 32598623 DOI: 10.26442/00403660.2019.02.000156] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Indexed: 12/25/2022]
Abstract
The multicenter prospective observational study initiated by the European Helicobacter and Microbiota Study Group (EHMSG) is conducted in 27 countries in Europe. The data from the Russian part of the European registry for the management of Helicobacter pylori infection (European Registry on the management of Helicobacter pylori infection, protocol: "Hp-EuReg") allows us to analyze the real clinical practice of diagnosis and treatment of H. pylori and compare it with international recommendations. MATERIALS AND METHODS A comparative analysis of the data entered in the register by the Russian research centers "Hp-EuReg", in the period from 2013 to 2018, was conducted. RESULTS AND DISCUSSION Invasive diagnostic methods prevail for the primary diagnosis of H. pylori [histology - 20.3% (in 2013 year) - 43.9% (in 2018 year), rapid urease test - 31.7% and 47.8% respectively]. The most popular mode of eradication therapy is a 10-day triple therapy (62.8-76.2%), the effectiveness of which does not exceed 79% (per protocol). Invasive tests (histology) are the leading method for control the effectiveness of therapy, however, there is a tendency towards a wider use of non-invasive methods (H. pylori stool antigen - from 17% in 2013 to 29.3% in 2018 and urea breath test from 6.9 to 18.3%, respectively). Serological test to control the effectiveness of eradication is still used from 8.2% (2013) to 6.1% (2018). Eradication therapy was not performed in 28% of patients throughout the entire observation period. CONCLUSION In Russia, despite approved domestic and international recommendations, deviations in clinical practice persist, both during eradication therapy and in monitoring the effectiveness of eradication therapy.
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Affiliation(s)
- D S Bordin
- A.S. Loginov Moscow Clinical Research and Practical Center of the Department of Health of Moscow
| | - Y V Embutnieks
- A.S. Loginov Moscow Clinical Research and Practical Center of the Department of Health of Moscow
| | | | | | - I N Voynovan
- A.S. Loginov Moscow Clinical Research and Practical Center of the Department of Health of Moscow
| | - A S Sarsenbaeva
- South Ural State Medical University of the Ministry of Health of the Russian Federation
| | | | - S A Alekseenko
- Far-Eastern State Medical University of the Ministry of Health of the Russian Federation
| | - R A Abdulkhakov
- Kazan State Medical University of the Ministry of Health of the Russian Federation
| | - N N Dehnich
- Smolensk State Medical University of the Ministry of Health of the Russian Federation
| | - M F Osipenko
- Novosibirsk State Medical University of the Ministry of Health of the Russian Federation
| | - M A Livzan
- Omsk State Medical University of the Ministry of Health of the Russian Federation
| | - V V Tsukanov
- Research Institute for Medical Problems of the North
| | - S G Burkov
- Polyclinic № 3 of the Department for Presidential Affairs of the Russian Federation
| | - N V Bakulina
- I.I. Mechnikov North-Western State Medical University of the Ministry of Health of the Russian Federation
| | - E Y Plotnikova
- Kemerovo State Medical Academy of the Ministry of Health of the Russian Federation
| | - L V Tarasova
- Republican Gastroenterology Center, Republican Clinical Hospital of the Ministry of Health and Social Development of Chuvashia.,I.N. Ulyanov Chuvash State University
| | - I V Maev
- A.I. Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of the Russian Federation
| | - Y A Kucheryavyi
- A.I. Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of the Russian Federation
| | - N V Baryshnikova
- I.P. Pavlov First Saint Petersburg State Medical University of the Ministry of Health of the Russian Federation
| | - M A Butov
- I.P. Pavlov Ryazan State Medical University of the Ministry of Health of the Russian Federation
| | - S V Kolbasnikov
- Tver State Medical University of the Ministry of Health of the Russian Federation
| | | | - T V Zhestkova
- I.P. Pavlov Ryazan State Medical University of the Ministry of Health of the Russian Federation
| | | | - S R Abdulhakov
- Kazan State Medical University of the Ministry of Health of the Russian Federation.,Kazan Federal University
| | - E A Ageeva
- Municipal outpatient clinic №3, Ministry of Health of Khabarovsk Region
| | - E A Lyalyukova
- Omsk State Medical University of the Ministry of Health of the Russian Federation
| | - A V Vasyutin
- Research Institute for Medical Problems of the North
| | - N N Golubev
- Polyclinic № 3 of the Department for Presidential Affairs of the Russian Federation
| | - I V Savilova
- I.I. Mechnikov North-Western State Medical University of the Ministry of Health of the Russian Federation
| | - L V Morkovkina
- Republican Gastroenterology Center, Republican Clinical Hospital of the Ministry of Health and Social Development of Chuvashia
| | - A G Kononova
- Tver State Medical University of the Ministry of Health of the Russian Federation
| | - F Megraud
- Laboratoire de Bactériologie, Hôpital Pellegrin
| | - C O'Morain
- Department of Gastroenterology, Tallaght Hospital/Trinity College Dublin
| | - M Ramas
- Gastroenterology Unit, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), and Universidad Autónoma de Madrid (UAM)
| | - O P Nyssen
- Gastroenterology Unit, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), and Universidad Autónoma de Madrid (UAM)
| | - A G McNicholl
- Gastroenterology Unit, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), and Universidad Autónoma de Madrid (UAM)
| | - J P Gisbert
- Gastroenterology Unit, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), and Universidad Autónoma de Madrid (UAM)
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Bordin DS, Voynovan IN, Kolbasnikov SV. EVIDENCE BASE OF LACTOBACILLUS REUTERI EFFICACY IN THE TREATMENT OF DISEASES ASSOCIATED WITH HELICOBACTER PYLORI. Eksp Klin Gastroenterol 2016:82-87. [PMID: 29874441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Helicobocterpylori (HP) - the human infection that persists for a long time in the stomach and can cause chronic gastritis, gastric and duodenal ulcer, MALT-lymphoma, gastric adenocarcinoma. There is a well-adapted niche-specific microbial community in the stomach represented by Lactobocillus, Streptococcus ahd other bacteria. Use of probiotics is considered to be an alternative or supplement to eradication therapy Among the Lactobacillus the most promising is Loctobocillus reutert who are able to have the anti-HP activity L. reureri produces powerful antimicrobial compounds such as reuterin, reuteritsin 6, reutetsiklin and metabolites that inhibit the growth of I-/P (volatile fatty acids, lactic acid, hydrogen peroxide, etc.). These compounds could reduce the adhesion of HP to gastric epithelial cells, inhibit growth HP, which leads to a significant reduction in the degree of contamination of HP and the severity of gastric mucosal inflammation. The data on the effectiveness of L. re uteri as monotherapy in patients with HP without absolute indications for eradication, and as an additional component, which increase the effectiveness of eradication are presented.
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