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

Nyssen, Olga P.; Vaira, Dino; Aísa, Ángeles Pérez; Rodrigo, Luís; Castro‐Fernández, Manuel; Jonaitis, Laimas Virginijus; Tepeš, Bojan; Вологжанина, Л. Г.; Caldas, María; Lanas, Ángel; Lucendo, Alfredo J.; Bujanda, Luís; Ortuño, Juan; Barrio, Jesús; Huguet, José María; Voynovan, Irina; Lasala, Jorge Pérez; Сарсенбаева, А. С.; Fernández-Salazar, Luis; Molina–Infante, Javier; Jurecic, Natasa Brglez; Areia, Miguel; Gasbarrini, Antonio; Kupčinskas, Juozas; Bordin, D.S.; Marcos-Pinto, Ricardo; Lerand, Frode; Leja, Mārcis; Buzás, György Miklós; Niv, Yaron; Rokkas, Theodore; Phull, Perminder; Smith, Sinead; Shvets, Oleg; Venerito, Marino; Milivojević, Vladimir; Şımşek, İlkay; Lamy, V.; Bytzer, Peter; Boyanova, Lyudmila; Kunovský, Lumír; Beglinger, Christoph; Doulberis, Michael; Marlicz, Wojciech; Goldiş, Adrian; Tonkić, Ante; Capelle, Lisette; Puig, Ignasi; Mégraud, Françis; Morain, Colm O; Gisbert, Javier P.

doi:10.1016/j.cgh.2021.12.025

Cited by 22 publications

(15 citation statements)

References 33 publications

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“… 30 Also, an Hp‐EuReg study performed on 5000 cases evaluating second‐line empirical therapy stated that regimens including 14‐day quinolone triple therapies, 14‐day levofloxacin–bismuth quadruple therapy, 14‐day classic BQT, and 10‐day BQT‐TSC, provided optimal effectiveness; the latter supporting current study results. 31 Furthermore, in the Hp‐EuReg sub‐study previously mentioned, second‐line therapy provided the highest cure rates with the 14‐day triple quinolone (PPI‐amoxicillin‐levofloxacin/moxifloxacin, 92% and 89%, respectively), the 14‐day bismuth‐levofloxacin quadruple schemes (PPI‐bismuth‐levofloxacin‐amoxicillin: 90%), and the 10‐day BQT‐TSC (88.5%), this latter regimen supporting as well current study findings. 29 …”

Section: Discussionmentioning

confidence: 99%

Effectiveness of first and second‐line empirical treatment in Italy: Results of the European registry on Helicobacter pylori management

et al. 2022

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Background and Aims:The optimal management of naïve and not naïve Helicobacter pylori patients remains unclear. Therefore, it is essential to evaluate whether the actual clinical practice mirrors the indications suggested by the guidelines. This study aimed to assess the effectiveness and the safety of the empirical first-and second-lineThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of first and second‐line empirical treatment in Italy: Results of the European registry on Helicobacter pylori management

et al. 2022

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“…With regards to empirical second line therapy, recent data from the Hp-EuReg reports eradication rates of >90% using different regimens. 247 Regularly monitoring eradication rates and local resistance patterns is key to guide the most appropriate empirical therapies. This information should be communicated to the Gastroenterology, Family practice and Public Health communities.…”

Section: Agreement 94% Grade D2mentioning

confidence: 99%

“…Given the current absence of strong data on tailoring second line and rescue therapies and still limited access to H. pylori culture or molecular testing, it will be some time before routine testing can become the expected approach for routine clinical use. With regards to empirical second line therapy, recent data from the Hp-EuReg reports eradication rates of >90% using different regimens 247. Regularly monitoring eradication rates and local resistance patterns is key to guide the most appropriate empirical therapies.…”

Section: Wg3: Treatmentmentioning

confidence: 99%

Management ofHelicobacter pyloriinfection: the Maastricht VI/Florence consensus report

Malfertheiner

Mégraud

Rokkas

et al. 2022

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Helicobacter pyloriInfection is formally recognised as an infectious disease, an entity that is now included in the International Classification of Diseases 11th Revision. This in principle leads to the recommendation that all infected patients should receive treatment. In the context of the wide clinical spectrum associated with Helicobacter pylori gastritis, specific issues persist and require regular updates for optimised management.The identification of distinct clinical scenarios, proper testing and adoption of effective strategies for prevention of gastric cancer and other complications are addressed. H. pylori treatment is challenged by the continuously rising antibiotic resistance and demands for susceptibility testing with consideration of novel molecular technologies and careful selection of first line and rescue therapies. The role of H. pylori and antibiotic therapies and their impact on the gut microbiota are also considered.Progress made in the management of H. pylori infection is covered in the present sixth edition of the Maastricht/Florence 2021 Consensus Report, key aspects related to the clinical role of H. pylori infection were re-evaluated and updated. Forty-one experts from 29 countries representing a global community, examined the new data related to H. pylori infection in five working groups: (1) indications/associations, (2) diagnosis, (3) treatment, (4) prevention/gastric cancer and (5) H. pylori and the gut microbiota. The results of the individual working groups were presented for a final consensus voting that included all participants. Recommendations are provided on the basis of the best available evidence and relevance to the management of H. pylori infection in various clinical fields.

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“…Although empirical therapy cannot provide individualized precision treatment compared with drug sensitivity therapy, it is an alternative in areas lack of medical facilities for laboratory testing. Moreover, there are also more studies showing that empirical treatment of refractory Helicobacter pylori infection has a good effect, with an eradication rate of 75–90% ( Gisbert, 2020 ; Ji et al, 2020 ; Nyssen et al, 2021 ). Since the main resistant antibiotics are clarithromycin, levofloxacin and metronidazole, more studies are needed to investigate the efficacy of other antibiotics as an empirical treatment option.…”

Section: Options For Rescue Treatment: Antibiotic-susceptibility Test...mentioning

confidence: 99%

Treatment of refractory Helicobacter pylori infection: A new challenge for clinicians

He²,

Zhu³

2022

Front. Microbiol.

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Patients who have failed two or more attempts to eradicate Helicobacter pylori are commonly referred to as refractory. Although the incidence of refractory Helicobacter pylori infection is only 10–20%, with the increasing rate of antibiotic resistance in various regions, the treatment of refractory Helicobacter pylori infection has gradually become a difficult problem faced by clinicians. When choosing a rescue therapy, the physician must consider numerous factors. A longer treatment duration, higher doses of proton pump inhibitors (PPIs), or the use of potassium-competitive acid blocker (P-CAB) may increase the efficacy of triple therapy or bismuth quadruple therapy. Rescue treatment based on bismuth quadruple therapy usually achieves better results. At the same time, treatment based on drug susceptibility tests or genotypic resistance is recommended where available. Of course, appropriate empiric treatment can also be selected according to local drug resistance, a patient’s previous medication history and compliance. It is the best choice if it can improve the success rate of the first treatment and reduce the occurrence of refractory Helicobacter pylori infection. This review aims to summarize the articles related to refractory Helicobacter pylori in recent years and to explore a better remedial treatment plan for clinicians.

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

Cited by 22 publications

References 33 publications

Effectiveness of first and second‐line empirical treatment in Italy: Results of the European registry on Helicobacter pylori management

Effectiveness of first and second‐line empirical treatment in Italy: Results of the European registry on Helicobacter pylori management

Management ofHelicobacter pyloriinfection: the Maastricht VI/Florence consensus report

Treatment of refractory Helicobacter pylori infection: A new challenge for clinicians

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