Nyssen OP, Vaira D, Saracino IM, Fiorini G, Caldas M, Bujanda L, Pellicano R, Keco-Huerga A, Pabón-Carrasco M, Oblitas Susanibar E, Di Leo A, Losurdo G, Pérez-Aísa Á, Gasbarrini A, Boltin D, Smith S, Phull P, Rokkas T, Lamarque D, Cano-Català A, Puig I, Mégraud F, O’Morain C, Gisbert JP. Experience with Rifabutin-Containing Therapy in 500 Patients from the European Registry on
Helicobacter pylori Management (Hp-EuReg).
J Clin Med 2022;
11:1658. [PMID:
35329984 PMCID:
PMC8949410 DOI:
10.3390/jcm11061658]
[Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/07/2022] [Accepted: 03/11/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND
First-line Helicobacter pylori (H. pylori) treatments have been relatively well evaluated; however, it remains necessary to identify the most effective rescue treatments. Our aim was to assess the effectiveness and safety of H. pylori regimens containing rifabutin.
METHODS
International multicentre prospective non-interventional European Registry on H. pylori Management (Hp-EuReg). Patients treated with rifabutin were registered in AEG-REDCap e-CRF from 2013 to 2021. Modified intention-to-treat and per-protocol analyses were performed. Data were subject to quality control.
RESULTS
Overall, 500 patients included in the Hp-EuReg were treated with rifabutin (mean age 52 years, 72% female, 63% with dyspepsia, 4% with peptic ulcer). Culture was performed in 63% of cases: dual resistance (to both clarithromycin and metronidazole) was reported in 46% of the cases, and triple resistance (to clarithromycin, metronidazole, and levofloxacin) in 39%. In 87% of cases rifabutin was utilised as part of a triple therapy together with amoxicillin and a proton-pump-inhibitor, and in an additional 6% of the patients, bismuth was added to this triple regimen. Rifabutin was mainly used in second-line (32%), third-line (25%), and fourth-line (27%) regimens, achieving overall 78%, 80% and 66% effectiveness by modified intention-to-treat, respectively. Compliance with treatment was 89%. At least one adverse event was registered in 26% of the patients (most frequently nausea), and one serious adverse event (0.2%) was reported in one patient with leukopenia and thrombocytopenia with fever requiring hospitalisation.
CONCLUSION
Rifabutin-containing therapy represents an effective and safe strategy after one or even several failures of H. pylori eradication treatment.
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