J 2022

Empirical Second-Line Therapy in 5000 Patients of the European Registry on Helicobacter pylori Management (Hp-EuReg)

NYSSEN, O. P., D. VAIRA, Á. PÉREZ AÍSA, L. RODRIGO, M. CASTRO-FERNANDEZ et. al.

Základní údaje

Originální název

Empirical Second-Line Therapy in 5000 Patients of the European Registry on Helicobacter pylori Management (Hp-EuReg)

Autoři

NYSSEN, O. P. (garant), D. VAIRA, Á. PÉREZ AÍSA, L. RODRIGO, M. CASTRO-FERNANDEZ, L. JONAITIS, B. TEPES, L. VOLOGZHANINA, M. CALDAS, A. LANAS, A. J. LUCENDO, L. BUJANDA, J. ORTUÑO, J. BARRIO, J. M. HUGUET, I. VOYNOVAN, J. P. LASALA, A. S. SARSENBAEVA, L. FERNANDEZ-SALAZAR, J. MOLINA-INFANTE, N. B. JURECIC, M. AREIA, A. GASBARRINI, J. KUPČINSKAS, D. BORDIN, R. MARCOS-PINTO, F. LERAND, M. LEJA, G. M. BUZAS, Y. NIV, T. ROKKAS, P. PHULL, S. SMITH, O. SHVETS, M. VENERITO, V. MILIVOJEVIC, I. SIMSEK, V. LAMY, P. BYTZER, L. BOYANOVA, Lumír KUNOVSKÝ (203 Česká republika, domácí), C. BEGLINGER, M. DOULBERIS, W. MARLICZ, A. GOLDIS, A. TONKIĆ, L. CAPELLE, I. PUIG, F. MEGRAUD, C. O. MORAIN a J. P. GISBERT

Vydání

Clinical Gastroenterology and Hepatology, New York, Elsevier, 2022, 1542-3565

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30219 Gastroenterology and hepatology

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Odkazy

Impakt faktor

Impact factor: 12.600

Kód RIV

RIV/00216224:14110/22:00125477

Organizační jednotka

Lékařská fakulta

UT WoS

000899945100018

Klíčová slova anglicky

Bismuth; Helicobacter pylori; Clarithromycin; Levofloxacin; Rescue

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 9. 2. 2023 08:31, Mgr. Tereza Miškechová

Anotace

V originále

Background & Aims After a first Helicobacter pylori eradication attempt, approximately 20% of patients will remain infected. The aim of the current study was to assess the effectiveness and safety of second-line empiric treatment in Europe. Methods This international, multicenter, prospective, non-interventional registry aimed to evaluate the decisions and outcomes of H pylori management by European gastroenterologists. All infected adult cases with a previous eradication treatment attempt were registered with the Spanish Association of Gastroenterology–Research Electronic Data Capture until February 2021. Patients allergic to penicillin and those who received susceptibility-guided therapy were excluded. Data monitoring was performed to ensure data quality. Results Overall, 5055 patients received empiric second-line treatment. Triple therapy with amoxicillin and levofloxacin was prescribed most commonly (33%). The overall effectiveness was 82% by modified intention-to-treat analysis and 83% in the per-protocol population. After failure of first-line clarithromycin-containing treatment, optimal eradication (>90%) was obtained with moxifloxacin-containing triple therapy or levofloxacin-containing quadruple therapy (with bismuth). In patients receiving triple therapy containing levofloxacin or moxifloxacin, and levofloxacin–bismuth quadruple treatment, cure rates were optimized with 14-day regimens using high doses of proton pump inhibitors. However, 3-in-1 single capsule or levofloxacin–bismuth quadruple therapy produced reliable eradication rates regardless of proton pump inhibitor dose, duration of therapy, or previous first-line treatment. The overall incidence of adverse events was 28%, and most (85%) were mild. Three patients developed serious adverse events (0.3%) requiring hospitalization. Conclusions Empiric second-line regimens including 14-day quinolone triple therapies, 14-day levofloxacin–bismuth quadruple therapy, 14-day tetracycline–bismuth classic quadruple therapy, and 10-day bismuth quadruple therapy (as a single capsule) provided optimal effectiveness. However, many other second-line treatments evaluated reported low eradication rates.