<i>Helicobacter pylori</i> infection treatment in the United States: clinical consequences and costs of eradication treatment failure

Shah, Shailja C.; Hubscher, Elizabeth; Pelletier, Corey; Jacob, Rinu; Vinals, Lydia; Yadlapati, Rena

doi:10.1080/17474124.2022.2056015

Cited by 20 publications

(14 citation statements)

References 102 publications

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“…The incidence rate and trend of three H. pylori -related cancers differed by race/ethnicity and geography, but the geographic variance for non-cardia GC was more pronounced and correlated with gender. Regarding the vital role H. pylori has played in the three malignancies, current international guidelines, including the American College of Gastroenterology, recommended H. pylori eradication in diagnosed infection, and a surveillance program, H. pylor i Antimicrobial Resistance Monitoring Program, was implemented nationwide ( 33 ), which might contribute to the control of H. pylori -related cancer. Nonetheless, to further achieve the goal of H. pylor i eradication, clarification of more cost-effective techniques of testing and therapy for H. pylori is warranted, especially the significance of screening programs and vaccines should be strengthened.…”

Section: Discussionmentioning

confidence: 99%

Incidence trends and disparities in Helicobacter pylori related malignancy among US adults, 2000–2019

Lai

Shi

Wang

et al. 2022

Front. Public Health

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BackgroundHelicobacter pylori (H. pylori) is closely related to the carcinogenesis of gastric cancer (GC) and gastric non-Hodgkin lymphoma (NHL). However, the systemic trend analysis in H. pylori-related malignancy is limited. We aimed to determine the national incidence trend in non-cardia GC, cardia GC, and gastric NHL in the US during 2000–2019.MethodIn this population-based study, we included 186,769 patients with a newly diagnosed H. pylori-related malignancy, including non-cardia GC, cardia GC, and gastric NHL from the Surveillance, Epidemiology, and End Results (SEER) Registry from January 1, 2000 to December 31, 2019. We determined the age-adjusted incidence of three H. pylori-related malignancies respectively. Average annual percentage change (AAPC) in 2000–2019 was calculated to describe the incidence trends. Analyses were stratified by sex, age, race and ethnicity, geographic location and SEER registries. We also determined the 5-year incidence (during 2015–2019) by SEER registries to examine the geographic variance.ResultsThe incidence in non-cardia GC and gastric NHL significantly decreased during 2000–2019, while the rate plateaued for cardia GC (AAPCs, −1.0% [95% CI, −1.1%−0.9%], −2.6% [95% CI, −2.9%−2.3%], and −0.2% [95% CI, −0.7%−0.3%], respectively). For non-cardia GC, the incidence significantly increased among individuals aged 20–64 years (AAPC, 0.8% [95% CI, 0.6–1.0%]). A relative slower decline in incidence was also observed for women (AAPC, −0.4% [95% CI, −0.6%−0.2%], P for interaction < 0.05). The incidence of cardia GC reduced dramatically among Hispanics (AAPC, −0.8% [95% CI, −1.4%−0.3%]), however it increased significantly among nonmetropolitan residents (AAPC, 0.8% [95% CI, 0.4–1.3%]). For gastric NHL, the decreasing incidence were significantly slower for those aged 20–64 years (AAPC, −1.5% [95% CI, −1.9–1.1%]) and Black individuals (AAPC, −1.3% [95% CI, −1.9–1.1%]). Additionally, the highest incidence was observed among Asian and the Black for non-cardia GC, while Whites had the highest incidence of cardia GC and Hispanics had the highest incidence of gastric NHL (incidence rate, 8.0, 8.0, 3.1, and 1.2, respectively) in 2019. Geographic variance in incidence rates and trends were observed for all three H. pylori-related malignancies. The geographic disparities were more pronounced for non-cardia GC, with the most rapid decline occurring in Hawaii (AAPC, −4.5% [95% CI, −5.5–3.6%]) and a constant trend in New York (AAPC 0.0% [95% CI, −0.4–0.4%]), the highest incidence in Alaska Natives, and the lowest incidence among Iowans (14.3 and 2.3, respectively).ConclusionThe incidence of H. pylori-related cancer declined dramatically in the US between 2000 and 2019, with the exception of cardia GC. For young people, a rising trend in non-cardia GC was noted. Existence of racial/ethnic difference and geographic diversity persists. More cost-effective strategies of detection and management for H. pylori are still in demand.

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Section: Discussionmentioning

confidence: 99%

Incidence trends and disparities in Helicobacter pylori related malignancy among US adults, 2000–2019

Lai

Shi

Wang

et al. 2022

Front. Public Health

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“…2 Helicobacter Pylori is considered to be a bug but it has its own way of causing detrimental effects . 3 The most common and hazardous outcome is gastritis or peptic ulcer disease in which the patients presents with agonizing pain long with hematemesis and malena . 4 If left untreated it can lead to gastrointestinal lymphoma as well and that's why experts try different therapies for its eradication .…”

Section: Introductionmentioning

confidence: 99%

Association Between Helicobacter pylori Infection and Nonalcoholic Fatty Liver Disease (NAFLD): A Cross-Sectional Study

Khan¹,

Fayaz²,

Wahab³

et al. 2023

PJMHS

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Background: In patients with gastrointestinal symptoms Helicobacter pylori has been known to cause non alcoholic fatty liver disease However, there is still gap in literature regarding it in our local clinical setting population. Objective: The study aims to determine association between Helicobacter pylori Infection and Nonalcoholic Fatty Liver Disease Materials & Methods: The cross-sectional study was done on 100 patients at the MMC General Hospital, from January 2022 to June 2022. Participants with both abdominal ultrasound (US) for diagnosing fatty liver disease and stool antigen for the detection of H. pylori infection were included. The pros and corns as well as rationale of the study were clearly explained to the participants with an option to withdraw from the study if needed .The data analysis was done by SPSS version 25. Results: Among cases 15(30%) patients were male and 35(70%) were female while among controls 16(32%) were male and 34(68%) were female. Among cases 35(70%) patients and among controls only 18(36%) participants were positive for H-Pylori. Frequency of H-Pylori infection was significantly higher among cases as that of controls. i.e. 70% vs. 36%, p-value<0.001 Odds ratio of 4.14 shows that among cases risk of H-pylori infection was 4.14 times higher as compared to controls. Data entry and analysis was done with SPSS version-25. Quantitative variables were presented with mean±SD and qualitative variables with frequency and percentage.Frequency of H-Pylori was compared among cases and controls with Chi Square test. Conclusion: There is an association between NAFLD and Hpylori indicating the need for regularly screening such patients. Keywords: NAFLD, H Pylori

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“…Hence, clarithromycin-based regimens are no longer generally recommended unless H. pylori susceptibility is confirmed, or local resistance is known to be <15%. 1,[15][16][17][18] In addition to resistance concerns, clarithromycin is acid-labile and degrades rapidly in the stomach when the intragastric pH falls below 5. 19 Despite this, clarithromycin-based triple therapy still accounts for over 80% of all H. pylori regimens prescribed in the US, 15 highlighting the urgent need for contemporary healthcare provider education.…”

Section: Introductionmentioning

confidence: 99%

“…Helicobacter pylori is a gram‐negative, primarily extracellular bacterium that colonises the human gastric mucosa leading to chronic inflammation. H. pylori infection is a leading cause of peptic ulcer disease, gastric adenocarcinoma, and gastric mucosa‐associated lymphoid tissue (MALT) lymphoma; successful eradication is associated with the reduced risk of these outcomes 1 . However, eradication of H. pylori has become increasingly difficult due to alarming contemporary antibiotic resistance rates, the reasons for which are multifactorial 2 .…”

Section: Introductionmentioning

confidence: 99%

“…H. pylori infection is a leading cause of peptic ulcer disease, gastric adenocarcinoma, and gastric mucosa-associated lymphoid tissue (MALT) lymphoma; successful eradication is associated with the reduced risk of these outcomes. 1 However, eradication of H. pylori has become increasingly difficult due to alarming contemporary antibiotic resistance rates, the reasons for which are multifactorial. 2 Since H. pylori is predominantly located in the gastric lumen and luminal crypts, relatively high doses of orally administered antibiotics are necessary for effective treatment.…”

Section: Introductionmentioning

confidence: 99%

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Physiologically‐based pharmacokinetic modelling to predict intragastric rifabutin concentrations in the treatment of Helicobacter pylori infection

Howden

Shah

Pendse³

et al. 2023

Aliment Pharmacol Ther

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Summary Background Sustained intragastric antibiotic exposure is important for Helicobacter pylori eradication, yet little is known about gastric pharmacology of commonly used H. pylori regimens. For rifabutin, differing intragastric concentrations based on dosing regimen may account for differences in reported eradication rates. Aim To compare intragastric rifabutin concentrations between low‐dose rifabutin (50 mg three time daily; as in RHB‐105) and generically dosed rifabutin 150 mg once daily, 150 mg twice daily, and 300 mg once daily using a validated Physiologically‐based pharmacokinetic (PBPK) model. Methods We obtained plasma pharmacokinetic data from the RHB‐105 clinical development programs and used it to develop and validate a whole‐body PBPK model using PK‐SIM software. We modified the existing rifabutin model to include the impact of omeprazole on gastric pH and emptying time. Modelled intragastric rifabutin exposure was expressed as the time that each regimen maintained its concentration ≥MIC90. Results Rifabutin 50 mg three times daily achieved significantly longer times with intragastric concentration above MIC90 (22.3 ± 1.1 h) than 150 mg once daily (8.3 ± 1.7 h), 150 mg twice daily (16.3 ± 2.3 h), or 300 mg once daily (8.5 ± 1.9 h) while providing the lowest mean maximal plasma concentration and mean area under the plasma concentration–time curve of all regimens studied. Conclusions PBPK modelling showed rifabutin 50 mg three times daily had higher intragastric exposure times than 150 mg once daily or twice daily, or 300 mg once daily. This low‐dose rifabutin regimen provides the highest potential for H. pylori eradication while minimising systemic rifabutin exposure.

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Helicobacter pylori infection treatment in the United States: clinical consequences and costs of eradication treatment failure

Cited by 20 publications

References 102 publications

Incidence trends and disparities in Helicobacter pylori related malignancy among US adults, 2000–2019

Incidence trends and disparities in Helicobacter pylori related malignancy among US adults, 2000–2019

Association Between Helicobacter pylori Infection and Nonalcoholic Fatty Liver Disease (NAFLD): A Cross-Sectional Study

Physiologically‐based pharmacokinetic modelling to predict intragastric rifabutin concentrations in the treatment of Helicobacter pylori infection

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