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Nyssen OP, Perez-Aisa A, Tepes B, Castro-Fernandez M, Kupcinskas J, Jonaitis L, Bujanda L, Lucendo A, Jurecic NB, Perez-Lasala J, Shvets O, Fadeenko G, Huguet JM, Kikec Z, Bordin D, Voynovan I, Leja M, Machado JC, Areia M, Fernandez-Salazar L, Rodrigo L, Alekseenko S, Barrio J, Ortuño J, Perona M, Vologzhanina L, Romero PM, Zaytsev O, Rokkas T, Georgopoulos S, Pellicano R, Buzas GM, Modolell I, Gomez Rodriguez BJ, Simsek I, Simsek C, Lafuente MR, Ilchishina T, Camarero JG, Dominguez-Cajal M, Ntouli V, Dekhnich NN, Phull P, Nuñez O, Lerang F, Venerito M, Heluwaert F, Tonkic A, Caldas M, Puig I, Megraud F, O'Morain C, Gisbert JP. Adverse Event Profile During the Treatment of Helicobacter pylori: A Real-World Experience of 22,000 Patients From the European Registry on H. pylori Management (Hp-EuReg). Am J Gastroenterol 2021; 116:1220-1229. [PMID: 33840725 DOI: 10.14309/ajg.0000000000001246] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 02/23/2021] [Indexed: 12/11/2022]
Abstract
INTRODUCTION The safety of Helicobacter pylori eradication treatments and to what extent adverse events (AEs) influence therapeutic compliance in clinical practice are hardly known. Our aim was to assess the frequency, type, intensity, and duration of AEs, and their impact on compliance, for the most frequently used treatments in the "European Registry on Helicobacter pylori management." METHODS Systematic prospective noninterventional registry of the clinical practice of European gastroenterologists (27 countries, 300 investigators) on the management of H. pylori infection in routine clinical practice. All prescribed eradication treatments and their corresponding safety profile were recorded. AEs were classified depending on the intensity of symptoms as mild/moderate/severe and as serious AEs. All data were subject to quality control. RESULTS The different treatments prescribed to 22,492 patients caused at least 1 AE in 23% of the cases; the classic bismuth-based quadruple therapy was the worst tolerated (37% of AEs). Taste disturbance (7%), diarrhea (7%), nausea (6%), and abdominal pain (3%) were the most frequent AEs. The majority of AEs were mild (57%), 6% were severe, and only 0.08% were serious, with an average duration of 7 days. The treatment compliance rate was 97%. Only 1.3% of the patients discontinued treatment due to AEs. Longer treatment durations were significantly associated with a higher incidence of AEs in standard triple, concomitant, bismuth quadruple, and levofloxacin triple or quadruple therapies. DISCUSSION Helicobacter pylori eradication treatment frequently induces AEs, although they are usually mild and of limited duration. Their appearance does not interfere significantly with treatment compliance.
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Affiliation(s)
- Olga P Nyssen
- Gastroenterology Unit, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain
| | - Angeles Perez-Aisa
- Gastroenterology Unit, Agencia Sanitaria Costa del Sol, Marbella, Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Málaga, Spain
| | - Bojan Tepes
- Gastroenterology Unit, AM DC Rogaska, Rogaska Slatina, Slovenia
| | | | - Juozas Kupcinskas
- Gastroenterology Unit, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Laimas Jonaitis
- Gastroenterology Unit, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Luis Bujanda
- Gastroenterology Unit, 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
| | - Alfredo Lucendo
- Gastroenterology Unit, Hospital de Tomelloso, Ciudad Real, Spain
| | | | | | - Oleg Shvets
- Gastroenterology Unit, Internal Diseases Department No. 1, National Medical University named after O.O. Bogomolets, Kyiv, Ukraine
| | - Galina Fadeenko
- Gastroenterology Unit, National Ukrainian Academy of Medical Sciences, Ukraine
| | - Jose M Huguet
- Gastroenterology Unit, Consorci Hospital General Universitari Valencia, Spain
| | - Zdenki Kikec
- Gastroenterology Unit, Hospital Slovenj Gradec, Slovenj Gradec, Slovenia
| | - Dmitry Bordin
- Gastroenterology Unit, A. S. Loginov Moscow Clinical Scientific Center, Moscow, Russia
- Gastroenterology Unit, Department of Outpatient Therapy and Family Medicine, Tver State Medical University, Tver, Russia
- Gastroenterology Unit, Department of Propaedeutic of Internal diseases and Gastroenterology, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
| | - Irina Voynovan
- Gastroenterology Unit, A. S. Loginov Moscow Clinical Scientific Center, Moscow, Russia
| | - Marcis Leja
- Gastroenterology Unit, Digestive Diseases Center GASTRO, Riga, Latvia
| | - Jose Carlos Machado
- Gastroenterology Unit, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, and Ipatimup-Institute of Molecular Pathology and Immunology of the University of Porto, Portugal
| | - Miguel Areia
- Gastroenterology Unit, Portuguese Oncology Institute of Coimbra, Portugal
| | | | - Luis Rodrigo
- Gastroenterology Unit, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Sergey Alekseenko
- Gastroenterology Unit, Far Eastern State Medical University Khabarovsk, Russia
| | - Jesus Barrio
- Gastroenterology Unit, Hospital Rio Hortega, Valladolid, Spain
| | - Juan Ortuño
- Gastroenterology Unit, Hospital Universitari I Politècnic La Fe Valencia, Spain
| | - Monica Perona
- Gastroenterology Unit, Hospital Quiron Marbella, Spain
| | | | - Pilar Mata Romero
- Gastroenterology Unit, Hospital San Pedro de Alcántara, Cáceres, Spain
| | - Oleg Zaytsev
- Gastroenterology Unit, First Clinical Medical Center Kovrov, Russia
| | - Theodore Rokkas
- Gastroenterology Unit, Henry Dunant Hospital, Athens, Greece
| | - Sotirios Georgopoulos
- Gastroenterology Unit, Athens Medical Center, Paleo Faliron General Hospital Athens, Greece
| | | | - Gyorgy M Buzas
- Gastroenterology Unit, Ferencváros Policlinic, Budapest, Hungary
| | - Ines Modolell
- Gastroenterology Unit, Consorci Sanitari Terrassa, Spain
| | | | - Ilkay Simsek
- Gastroenterology Unit, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Cem Simsek
- Gastroenterology Unit, Hacettepe University Ankara, Turkey
| | | | | | | | | | | | | | - Perminder Phull
- Gastroenterology Unit, Aberdeen Royal Infirmary Aberdeen, United Kingdom
| | - Oscar Nuñez
- Gastroenterology Unit, Hospital Universitario Sanitas La Moraleja, Madrid, Spain
| | - Frode Lerang
- Gastroenterology Unit, Medical Department, Central Hospital Ostfold, Fredrikstad, Norway
| | - Marino Venerito
- Gastroenterology Unit, Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University Hospital, Magdeburg, Germany
| | - Frederic Heluwaert
- Gastroenterology Unit, Center Hospitalier Annecy Genvois, Pringy, France
| | - Ante Tonkic
- Gastroenterology Unit, University Hospital of Split, School of Medicine, University of Split, Croatia
| | - Maria Caldas
- Gastroenterology Unit, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain
| | - Ignasi Puig
- Gastroenterology Unit, Althaia Xarxa Assistencial Universitària de Manresa and Universitat de Vic-Universitat Central de Catalunya (UVicUCC), Manresa, Spain
| | - Francis Megraud
- Gastroenterology Unit, Laboratoire de Bactériologie, Hôpital Pellegrin, Bordeaux, France
| | - Colm O'Morain
- Gastroenterology Unit, Department of Clinical Medicine, Trinity College Dublin, Ireland
| | - Javier P Gisbert
- Gastroenterology Unit, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain
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Zakharenkov IA, Rachina SA, Dekhnich NN, Kozlov RS, Sinopalnikov AI, Ivanchik NV, Yatsyshina SB, Elkina MA, Archipenko MV, Gordeeva SA, Lebedeva MS, Portnyagina US. [Etiology of severe community - acquired pneumonia in adults: results of the first Russian multicenter study]. TERAPEVT ARKH 2020; 92:36-42. [PMID: 32598661 DOI: 10.26442/00403660.2020.01.000491] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 04/16/2020] [Indexed: 11/22/2022]
Abstract
AIM to study the etiology of severe community - acquired pneumonia (SCAP) in adults in Russian Federation. SCAP is distinguished by high mortality and socio - economic burden. Both etiology and antimicrobial resistance are essential for appropriate antibiotic choice. MATERIALS AND METHODS A prospective cohort study recruited adults with confirmed diagnosis of SCAP admitted to multi - word hospitals of six Russian cities in 2014-2018. Etiology was confirmed by routine culture of blood, respiratory (sputum, endotracheal aspirate or bronchoalveolar lavage) and when appropriate, autopsy samples, urinary antigen tests (L. pneumophila serogroup 1, S. pneumoniae); real - time PCR for identification of "atypical" bacterial pathogens (M. pneumoniae, C. pneumoniae, L. pneumophila) and respiratory viruses (influenza viruses A and B, parainfluenza, human metapneumovirus, etc.) was applied. RESULTS Altogether 109 patients (60.6% male; mean age 50.8±18.0 years old) with SCAP were enrolled. Etiological agent was identified in 65.1% of patients, S. pneumoniae, rhinovirus, S. aureus and K. pneumoniae were the most commonly isolated pathogens (found in 43.7, 15.5, 14.1 and 11.3% of patients with positive results of microbiological investigations, respectively). Bacteriemia was seen in 14.6% of patients and most commonly associated with S. pneumoniae. Co - infection with 2 or more causative agents was revealed in 36.6% of cases. Combination of bacterial pathogens (mainly S. pneumoniae with S. aureus or/and Enterobacterales) prevailed - 57.7% of cases; associations of bacteria and viruses were identified in 38.5% of patients, different viruses - in one case. CONCLUSION S. pneumoniae was the most common pathogen in adults with SCAP. A high rate of respiratory viruses (mainly rhinovirus and influenza viruses) identification both as mixt infection with bacteria and mono - infection should be taken into account.
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Affiliation(s)
- I A Zakharenkov
- Bryansk city hospital №1.,The Interregional Association for Clinical Microbiology and Antimicrobial Chemotherapy
| | | | | | - R S Kozlov
- The Interregional Association for Clinical Microbiology and Antimicrobial Chemotherapy.,Smolensk State Medical University
| | | | | | | | - M A Elkina
- Central Research Institute of Epidemiology
| | | | - S A Gordeeva
- P.A. Bayandin Murmansk State Regional Clinical Hospital
| | - M S Lebedeva
- State Budgetary Healthcare Institution «Saint-Petersburg clinical scientific and practical center for specialised types of medical care (oncological)»
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Bordin DS, Embutnieks YV, Vologzhanina LG, Il'chishina TA, Voinovan IN, Sarsenbaeva AS, Alekseenko SA, Zaitsev OV, Abdulkhakov RA, Osipenko MF, Livzan MA, Tsukanov VV, Burkov SG, Bakulina NV, Dekhnich NN, Tarasova LV, Plotnikova EY, Maev IV, Kucheryavyi YA, Baryshnikova NV, Butov MA, Kolbasnikov SV, Pakhomova AL, Zhestkova TV, Baranovskii AY, Abdulkhakov 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 on the management of Helicobacter pylori infection (Hp-EuReg): analysis of 2360 patients receiving first-line therapy in Russia. TERAPEVT ARKH 2019; 90:35-42. [PMID: 30701770 DOI: 10.26442/terarkh201890235-42] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
AIM European Registry on the management of Helicobacter pylori infection («Hp-EuReg») - a multicenter prospective observational study initiated by the European Helicobacter and Microbiota Study Group, conducted in 27 European countries in order to evaluate the real clinical practice of diagnosis and treatment of H. pylori and its comparison with international recommendations. MATERIALS AND METHODS The analysis of 2360 patients entered in the register by the Russian centres of «Hp-EuReg» in 2013-2017, who were underwent 1st line eradication therapy. RESULTS The most common methods of primary diagnosis of H. pylori are histological (37.7%), rapid urease test (29.2%) and serology (29.7%). The duration of eradication therapy in 9.4% of cases was 7 days, in 65.3% - 10 days, and in 25.3% - 14 days. To control the effec- tiveness of treatment, H. pylori antigen in feces (31.3%), urea breath test (23.4%) and histological method (23.3%) were used. In 3.6% cases was used serology by mistake. In 17.3% of patients control was not carried out. The effectiveness of triple therapy with a PPI, amoxicillin, clar- ithromycin (per protocol) was 67.6%, with 7-day course, 81.1% at 10-day and 86.7% at 14-day course. Eradication rate of triple therapy with addition of bismuth (per protocol) reached 90,6% in the group receiving 10-day scheme and 93.6% in the group receiving the 14-day treatment. CONCLUSION Significant deviations of clinical practice from expert recommendations, most pronounced at the stage of monitoring the effectiveness of therapy, were noted. The suboptimal efficacy of triple therapy is shown.
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Affiliation(s)
- D S Bordin
- A.S. Loginov Moscow clinical scientific practical center of Moscow Healthcare Department , Moscow, Russia.,Tver state medical University, Ministry of health of Russia, Tver, Russia
| | - Yu V Embutnieks
- A.S. Loginov Moscow clinical scientific practical center of Moscow Healthcare Department , Moscow, Russia
| | | | | | - I N Voinovan
- A.S. Loginov Moscow clinical scientific practical center of Moscow Healthcare Department , Moscow, Russia
| | - A S Sarsenbaeva
- South Ural state medical University, Ministry of Health of Russia, Chelyabinsk, Russia
| | - S A Alekseenko
- Far Eastern State Medical University, Ministry of Health of Russia, Khabarovsk, Russia
| | - O V Zaitsev
- The First clinical medical center, Kovrov, Russia
| | - R A Abdulkhakov
- Kazan state medical University, Ministry of Health of Russia, Kazan, Russia
| | - M F Osipenko
- Novosibirsk state medical University, Ministry of Health of Russia, Novosibirsk, Russia
| | - M A Livzan
- Omsk state medical University, Ministry of health of Russia, Omsk, Russia
| | - V V Tsukanov
- Krasnoyarsk scientific center of the Siberian branch of the Russian Academy of Sciences, separat of division "Scientific research Institute of medical problems of the North", Krasnoyarsk, Russia
| | - S G Burkov
- Polyclinic №3 of Department for presidential Affairs of the Russian Federation, Moscow, Russia
| | - N V Bakulina
- I.I. Mechnikov North-Western state medical University, Ministry health of Russia, St. Petersburg, Russia
| | - N N Dekhnich
- Smolensk state medical University Ministry of health of Russia, Smolensk, Russia
| | - L V Tarasova
- Republican gastroenterology center, "Republican clinical hospital", Ministry of health of Chuvash Republic, I.N. Ulyanov state University, Cheboksary, Russia
| | - E Yu Plotnikova
- Kemerovo state medical University, Ministry health of Russia, Kemerovo, Russia
| | - I V Maev
- A.I. Evdokimov Moscow state medical dental University, Ministry of Health of Russia, Moscow, Russi
| | - Yu A Kucheryavyi
- A.I. Evdokimov Moscow state medical dental University, Ministry of Health of Russia, Moscow, Russi
| | - N V Baryshnikova
- Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia, St. Petersburg, Russia
| | - M A Butov
- I.P. Pavlov Ryazan State Medical University, Ministry of health of Russia, Ryazan, Russia
| | - S V Kolbasnikov
- Tver state medical University, Ministry of health of Russia, Tver, Russia
| | - A L Pakhomova
- V. I. Razumovsky Saratov state medical University, Ministry of health of Russia, Saratov, Russia
| | - T V Zhestkova
- I.P. Pavlov Ryazan State Medical University, Ministry of health of Russia, Ryazan, Russi
| | | | - S R Abdulkhakov
- Kazan state medical University, Ministry of Health of Russia, Kazan, Russia.,Kazan (Volga region) Federal University, Kazan, Russia
| | - E A Ageeva
- Far Eastern State Medical University, Ministry of Health of Russia, Khabarovsk, Russia
| | - E A Lyalyukova
- Omsk state medical University, Ministry of health of Russia, Omsk, Russia
| | - A V Vasyutin
- Krasnoyarsk scientific center of the Siberian branch of the Russian Academy of Sciences, separat of division "Scientific research Institute of medical problems of the North", Krasnoyarsk, Russia
| | - N N Golubev
- Polyclinic №3 of Department for presidential Affairs of the Russian Federation, Moscow, Russia
| | - I V Savilova
- I.I. Mechnikov North-Western state medical University, Ministry health of Russia, St. Petersburg, Russia
| | - L V Morkovkina
- Republican gastroenterology center, "Republican clinical hospital", Ministry of health of Chuvash Republic, I.N. Ulyanov state University, Cheboksary, Russia
| | - A G Kononova
- Tver state medical University, Ministry of health of Russia, Tver, Russia
| | - F Megraud
- Laboratoire of Bacteriology, Hospital Pellegrin, Bordeaux, France
| | - C O'Morain
- Department of Gastroenterology, Tallaght Hospital/Trinity College Dublin, Dublin, Ireland
| | - M Ramas
- Gastroenterology Unit, University Hospital «Princess», the Institute of Research in Health "Princess" (IIS-IP), Biomedical Research Centre Network of Hepatic and Digestive Diseases (CIBERehd), and Autonomous University of Madrid (UAM), Madrid, Spain
| | - O P Nyssen
- Gastroenterology Unit, University Hospital «Princess», the Institute of Research in Health "Princess" (IIS-IP), Biomedical Research Centre Network of Hepatic and Digestive Diseases (CIBERehd), and Autonomous University of Madrid (UAM), Madrid, Spain
| | - A G McNicholl
- Gastroenterology Unit, University Hospital «Princess», the Institute of Research in Health "Princess" (IIS-IP), Biomedical Research Centre Network of Hepatic and Digestive Diseases (CIBERehd), and Autonomous University of Madrid (UAM), Madrid, Spain
| | - J P Gisbert
- Gastroenterology Unit, University Hospital «Princess», the Institute of Research in Health "Princess" (IIS-IP), Biomedical Research Centre Network of Hepatic and Digestive Diseases (CIBERehd), and Autonomous University of Madrid (UAM), Madrid, Spain
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