Consensus on eradication of <i>Helicobacter pylori</i> and prevention and control of gastric cancer in China (2019, Shanghai)

Du, Yiqi; Liu, Jiong; Li, Jingnan; Chang, Xin; Zhou, Liya; Chen, Minhu; Lü, Nonghua; Li, Zhao‐Shen

doi:10.1111/jgh.14947

Cited by 61 publications

(51 citation statements)

References 46 publications

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“…effective strategy in high-risk areas. 28 The main reason for economic gains of H. pylori eradication therapy was that it reduced the incidence of gastric cancer, thereby reducing the total costs of gastric cancer. Nevertheless, in addition to the treatment costs, multiple factors including drug availability, and antibiotic resistance needs to be taken into consideration when carrying out a screen-and-treat program for H. pylori in the whole country, especially in countries with large populations and limited medical resources.…”

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confidence: 99%

Cost‑effectiveness Analysis of Helicobacter pylori Eradication Therapy in First-Degree Relatives of Patients with Gastric Cancer

Zheng

Xie

Zhan

et al. 2021

PPA

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Background: Helicobacter pylori (H. pylori) eradication therapy has been shown to reduce the risk of gastric cancer in patients who have a family history of gastric cancer in firstdegree relatives. The aim of this study was to assess the cost-effectiveness of H. pylori eradication therapy in a select population in the People's Republic of China. Methods: A Markov model was applied to evaluate the cost-effectiveness of H. pylori eradication therapy. The long-term costs of H. pylori eradication therapy were calculated from the Chinese perspective. Health outcomes were measured by quality-adjusted life years (QALYs). Epidemiological information and health utilities used in the model were collected from published literatures or statistical bureaus. A sensitivity analysis was conducted to explore the influence of parameters on the uncertainty of the model. Results: Compared with the no eradication therapy group, H. pylori eradication therapy prolonged an average of 4.52 QALYs (32.64 QALYs vs 28.12 QALYs) and saved $3227.07 ($2472.83 vs $5699.90). The cost-effectiveness analysis demonstrated that no H. pylori eradication therapy cost more and produced less QALYs. It was dominated by H. pylori eradication therapy. The one-way sensitive analyses proved that the results were robust to the fluctuations of the input parameters. Conclusion: H. pylori eradication therapy not only reduced the risk of gastric cancer in first-degree relatives of patients with gastric cancer but also was an economical strategy with lower costs and greater efficacy.

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confidence: 99%

Cost‑effectiveness Analysis of Helicobacter pylori Eradication Therapy in First-Degree Relatives of Patients with Gastric Cancer

Zheng

Xie

Zhan

et al. 2021

PPA

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“…Patients were eligible if they had a confirmed H. pylori infection based on the 13 C-urea breath test (UBT). The following exclusion criteria were used: (1) patients who had received H. pylori eradication treatment more than once; (2) patients who had been treated with antibiotics, colloidal bismuth pectin, H 2 receptor inhibitors, or PPIs within the previous 4 weeks; (3) patients with a history of fluoroquinolone drug treatment, particularly levofloxacin; (4) patients with serious diseases, such as severe cardiopulmonary and liver dysfunction; and (5) patients with an allergy to the study drugs. Each patient provided written informed consent, and the study protocol was approved by the ethics committee of each center.…”

Section: Participantsmentioning

confidence: 99%

“…H. pylori infection is associated with risks of peptic ulcer, chronic gastritis, intestinal metaplasia, and gastric cancer [2]. Therefore, consensus reports have proposed that H. pylori eradication treatment is necessary to prevent these diseases [2,3], particularly among patients who have a family history of gastric cancer in first-degree relatives [4]. Unfortunately, the eradication rates of standard therapy have decreased to alarmingly low levels due to increasing levels of antibiotic resistance; eradication is particularly difficult when the clarithromycin resistance rate is greater than 15% in the local region [5,6].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of tailored second-line therapy of Helicobacter pylori eradication in patients with clarithromycin-based treatment failure: a multicenter prospective study

Kong

Huang

Wang³

et al. 2020

Gut Pathog

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Background: After the failure of clarithromycin-and bismuth-based quadruple therapy (CBQT), levofloxacin-and bismuth-based quadruple therapy (LBQT) is recommended for Helicobacter pylori eradication. We compared the efficacies of second-line tailored bismuth-based quadruple therapy (TBQT) and empirical LBQT. Methods: Patients with CBQT failure were randomly assigned to receive TBQT or LBQT for 14 days. All patients underwent endoscopy for culture-based antibiotic susceptibility testing. Patients in the TBQT group exhibiting levofloxacin susceptibility were randomized to receive amoxicillin, levofloxacin, esomeprazole, and colloidal bismuth pectin (ALEB) or amoxicillin, furazolidone, esomeprazole, and colloidal bismuth pectin (AFEB) for 14 days; patients with levofloxacin resistance received AFEB. Results: From May 2016 to June 2019, 364 subjects were enrolled. Eradication rates were significantly higher in the TBQT group (n = 182) than in the LBQT group (n = 182) according to both intention-to-treat (ITT) analysis (89.6% vs. 64.8%, P < 0.001) and per protocol (PP) analysis (91.1% vs. 67.8%, P < 0.001). Among patients in the TBQT group with levofloxacin susceptibility, eradication rates were similar in the ALEB (n = 51) and AFEB (n = 50) subgroups according to both the ITT (86.3% vs. 90.0%, P = 0.56) and PP (88.0% vs. 90.0%, P = 0.75) analyses. Isolated clarithromycin and levofloxacin resistance rates were 57.7% and 44.5%, respectively. The total clarithromycin and levofloxacin resistance rate in strains with dual or triple resistance was 35.7%. Conclusions: TBQT was more effective than LBQT as a second-line strategy after CBQT failure. In the absence of antibiotic susceptibility testing, AFEB therapy might be used as a rescue therapy to eradicate H. pylori and avoid levofloxacin resistance. Trial registration: Chinese Clinical Trial Registry (www.chict r.org.cn): ChiCTR1900027743.

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“…In recent decades, the urea breath test has been widely used to detect H. pylori infection not only in specialized hospitals but also in physical examination centers and community hospitals in China. This has led to large numbers of asymptomatic patients being referred to specialized clinics for treatment[ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Current status of Helicobacter pylori eradication and risk factors for eradication failure

Yan¹,

Wang²,

Chen³

et al. 2020

WJG

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BACKGROUND The Helicobacter pylori ( H. pylori ) eradication rate is decreasing in the general population of China. AIM To evaluate the H. pylori eradication status in real-world clinical practice and to explore factors related to eradication failure. METHODS Patients with H. pylori infection who were treated with standard 14-d quadruple therapy and received a test of cure at a provincial medical institution between June 2018 and May 2019 were enrolled. Demographic and clinical data were recorded. Eradication rates were calculated and compared between regimens and subgroups. Multivariate analysis was performed to identify predictors of eradication failure. RESULTS Of 2610 patients enrolled, eradication was successful in 1999 (76.6%) patients. Amoxicillin-containing quadruple regimens showed a higher eradication rate than other quadruple therapy regimens (83.0% vs 69.0%, P < 0.001). The quadruple therapy containing amoxicillin plus clarithromycin achieved the highest eradication rate (83.5%). Primary therapy had a higher eradication rate than rescue therapy (78.3% vs 66.5%, P < 0.001). In rescue therapy, the amoxicillin- and furazolidone-containing regimens achieved the highest eradication rate (80.8%). Esomeprazole-containing regimens showed a higher eradication rate than those containing other proton pump inhibitors (81.8% vs 74.9%, P = 0.001). Multivariate regression analysis found that older age, prior therapy, and use of omeprazole or pantoprazole were associated with an increased risk of eradication failure. CONCLUSION The total eradication rate is 76.6%. Amoxicillin-containing regimens are superior to other regimens. Age, prior therapy, and use of omeprazole or pantoprazole are independent risk factors for eradication failure.

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Consensus on eradication of Helicobacter pylori and prevention and control of gastric cancer in China (2019, Shanghai)

Cited by 61 publications

References 46 publications

Cost‑effectiveness Analysis of Helicobacter pylori Eradication Therapy in First-Degree Relatives of Patients with Gastric Cancer

Cost‑effectiveness Analysis of Helicobacter pylori Eradication Therapy in First-Degree Relatives of Patients with Gastric Cancer

Efficacy of tailored second-line therapy of Helicobacter pylori eradication in patients with clarithromycin-based treatment failure: a multicenter prospective study

Current status of Helicobacter pylori eradication and risk factors for eradication failure

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