Indications of Helicobacter pylori Eradication Treatment and Its Influence on Prescriptions and Effectiveness (Hp-EuReg)

Martínez-Domínguez SJ 1 , Nyssen OP 2 , Lanas Á 1 , Alfaro E 1 , Jonaitis L 3 , Mahmudov U 4 Show all authors , Voynovan I 5 , Gülüstan B 6 , Rodrigo L 7 , Fiorini G 8 , Perez-Aisa Á 9 , Tejedor-Tejada J 10 , Tepes B 11 , Vologzanina L 12 , Mammadov E 6 , Lerang F 13 , Oğlu QFV 14 , Bakulina NV 15 , Abdulkhakov R 16 , Tatiana I 17 , Butler TJ 18 , Sarsenbaeva AS 19 , Bumane R 20 , Lucendo AJ 21 , Romano M 22 , Bujanda L 23 , Abdulkhakov SR 15 , Zaytsev O 24 , Pabón-Carrasco M 25 , Keco-Huerga A 25 , Denkovski M 26 , Huguet JM 27 , Perona M 28 , Núñez Ó 29 , Pavoni M 8 , Fadieienko G 30 , Alekseenko S 31 , Smith SM 32 , Hernández L 33 , Kupcinskas J 34 , Bordin DS 35 , Leja M 36 , Gasbarrini A 37 , Gridnyev O 30 , Cano-Català A 38 , Parra P 2 , Moreira L 39 , Mégraud F 40 , O'Morain C 41 , Gisbert JP 2 , Hp‐EuReg Investigators

Affiliations 

  • 1 Department of Gastroenterology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
  • 2 Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Hospital Universitario de La Princesa, Universidad Autónoma de Madrid (UAM), Madrid, Spain
  • 3 Department of Gastroenterology, Lithuanian University of Health Sciences, Kaunas, Lithuania
  • 4 Modern Hospital, Baku, Azerbaijan
  • 5 Department of Gastroenterology, A.S. Loginov Moscow Clinical Scientific Center, Moscow, Russia
  • 6 Azerbaijan State Advanced Training Institute for Doctors Named by A.Aliyev, Baku, Azerbaijan
  • 7 Department of Gastroenterology, University of Oviedo, Oviedo, Spain
  • 8 IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
  • 9 Department of Gastroenterology, Redes de Investigación Cooperativa Orientada a Resultados en Salud (RICORS), Hospital Universitario Costa del Sol, Marbella, Spain
  • 10 Department of Gastroenterology, Hospital Universitario de Cabueñes, Gijón, Asturias, Spain
  • 11 Department of Gastroenterology, DC Rogaska, Rogaska Slatina, Slovenia
  • 12 Gastrocenter, Perm, Russia
  • 13 Østfold Hospital Trust, Grålum, Norway
  • 14 National Oncology Centre, Baku, Azerbaijan
  • 15 I.I. Mechnikov North-Western State Medical University of the Ministry of Health of the Russian Federation, Saint Petersburg, Russia
  • 16 Department of Hospital Medicine, Kazan State Medical University, Kazan, Russia
  • 17 Department of Gastroenterology, SM-Clinic, Saint-Petersburg, Russia
  • 18 Department of Gastroenterology, Clinical Medicine, Trinity College Dublin, Tallaght University Hospital, Dublin, Ireland
  • 19 Department of Gastroenterology, Chelyabinsk Regional Clinical Hospital, Chelyabinsk, Russia
  • 20 Digestive Diseases Centre GASTRO, Riga, Latvia
  • 21 Department of Gastroenterology, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Hospital General de Tomelloso, Tomelloso, Spain
  • 22 Gastroenterology and Endoscopy Unit, Dipartimento di Medicina di Precisione, Università Vanvitelli, Naples, Italy
  • 23 Centro de Investigación Biomédica en Red en Enfermedades Digestivas y Hepáticas (CIBERehd), Madrid, Spain
  • 24 First Clinical Medical Centre, Kovrov, Russia
  • 25 Department of Gastroenterology, Hospital Universitario de Valme, Sevilla, Spain
  • 26 Interni Oddelek, Diagnostic Centre, Bled, Slovenia
  • 27 Department of Gastroenterology, Hospital General Universitario de Valencia, Valencia, Spain
  • 28 Department of Gastroenterology, Hospital Quirón Marbella, Marbella, Spain
  • 29 Department of Gastroenterology, Hospital Universitario Sanitas La Moraleja, Madrid, Spain
  • 30 Department the Division for the Study of the Digestive Diseases and its Comorbidity with Noncommunicable Diseases, Government Institution L.T. Malaya Therapy National Institute of NAMS of Ukraine, Kharkiv, Ukraine
  • 31 Far Eastern State Medical University, Khabarovsk, Russia
  • 32 School of Medicine, Trinity College Dublin, Dublin, Ireland
  • 33 Gastroenterology Unit, Hospital Santos Reyes, Aranda de Duero, Spain
  • 34 Department of Gastroenterology, Institute for Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania
  • 35 Department of Pancreatic, Biliary and Upper Digestive Tract Disorders, A. S. Loginov Moscow Clinical Scientific Center, Moscow, Russia
  • 36 Department of Gastroenterology, Digestive Diseases Centre, Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia
  • 37 Medicina Interna e Gastroenterologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
  • 38 Gastrointestinal Oncology, Endoscopy and Surgery (GOES) Research Group, Institut de Recerca i Innovació en Ciències de la Vida i de la Salut de la Catalunya Central (IRIS-CC), Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Spain
  • 39 Department of Gastroenterology, Centro de Investigación Biomédica en red en Enfermedades Hepáticas y Digestivas (CIBERehd), Institut d'Investigacions Biomèdiques August pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
  • 40 INSERM U1312 Bric, Université de Bordeaux, Bordeaux, France
  • 41 Faculty of Health Sciences, Trinity College Dublin, Dublin, Ireland
Helicobacter, 2024;29(4):e13111.
PMID: 39001621 DOI: 10.1111/hel.13111

Abstract

BACKGROUND: The influence of indications for Helicobacter pylori investigation on prescriptions and effectiveness is unknown. The aim of the study was to assess the impact of indications for H. pylori investigation on prescriptions, effectiveness, compliance, and tolerance.

METHODS: International, prospective, non-interventional registry of the management of H. pylori infection by European gastroenterologists (Hp-EuReg). Treatment-näive patients registered from 2013 to 2023 at e-CRF AEG-REDCap were analyzed. The effectiveness was assessed by modified intention-to-treat analysis.

RESULTS: Overall, 53,636 treatment-naïve cases from 34 countries were included. Most frequent indications were: dyspepsia with normal endoscopy (49%), non-investigated dyspepsia (20%), duodenal ulcer (11%), gastric ulcer (7.7%), and gastroesophageal reflux disease (GERD) (2.6%). Therapy effectiveness varied by indication: duodenal ulcer (91%), gastric ulcer (90%), preneoplastic lesions (90%), dyspepsia with normal endoscopy (89%), GERD (88%), and non-investigated dyspepsia (87%). Bismuth-metronidazole-tetracycline and clarithromycin-amoxicillin-bismuth quadruple therapies achieved 90% effectiveness in all indications except GERD. Concomitant clarithromycin-amoxicillin-tinidazole/metronidazole reached 90% cure rates except in patients with non-investigated dyspepsia; whereas sequential clarithromycin-amoxicillin-tinidazole/metronidazole proved optimal (≥90%) in patients with gastric ulcer only. Adverse events were higher in patients treated for dyspepsia with normal endoscopy and duodenal ulcer compared with the remaining indications (23% and 28%, p 

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