Helicobacter pylori test‐and‐treat strategy for second‐year junior high school students aimed at the prevention of gastric cancer in Takatsuki City

Abstract

BackgroundMore than 90% of gastric cancer cases are caused by Helicobacter pylori infections. To prevent gastric cancer, an H pylori test‐and‐treat strategy targeting young people has been implemented in various places in Japan. In this study, we evaluated the effectiveness of an H pylori test‐and‐treat strategy for second‐year junior high school students in Takatsuki City.Materials and MethodsIn 2014‐2017, a urine‐based H pylori test was used for initial screening. The final infection status was determined by a 13C‐urea breath test (13C‐UBT). Successful H pylori eradication was confirmed by 13C‐UBT 3 months after treatment. First‐line eradication therapy was changed from 10 mg of rabeprazole, 750 mg of amoxicillin, and 200 mg of clarithromycin twice daily for 7 days in 2014 to 20 mg of vonoprazan, 750 mg of amoxicillin, and 200 mg of clarithromycin twice daily for 7 days in 2015‐2017. Second‐line eradication therapy included 10 mg of rabeprazole, 750 mg of amoxicillin, and 250 mg of metronidazole twice daily for 7 days.ResultsIn total, 8067 of 13 055 students participated this project and 206 students were diagnosed with H pylori infection. The success rate of first‐line therapy was 45.9% in 2014 and 83.8% after the revised first‐line therapy was administered. The final eradication rate was 98.5%. There were no severe side effects.ConclusionOur results support the use of the H pylori test‐and‐treat strategy for junior high school students as a safe approach for the prevention of gastric cancer. H pylori eradication therapy with vonoprazan could be a standard therapy in children.

Gastrointestinal adverse reactions reduce the success rate of Helicobacter pylori eradication therapy: A multicenter prospective cohort study

“…Thus, it can be considered that the eradication of H. pylori infection in younger generation is beneficial, and recent studies indicated the successful eradication of H. pylori using eradication protocols for adult; however, detailed information regarding the adverse reactions was not included in the study 9–11 . Recently, several studies in Japan have performed H. pylori eradication therapy in junior high school students to prevent the further carcinogenesis of H. pylori infection, including our previous studies 7,12–14 . These studies have clearly indicated adverse reactions related to the eradication therapy in children.…”

Gut microbiota changes related to Helicobacter pylori eradication with vonoprazan containing triple therapy among adolescents: a prospective multicenter study

“…However, these were not serious adverse events. The safety of eradication therapy of H. pylori with triple therapy containing vonoprazan fumarate for adolescents remains unclear; however, reports have shown no major problems in short-term evaluations 9,12,16 . In the present study, the number of cases was limited, and only adverse events during oral administration of antibacterial drugs and P-CAB were evaluated.…”

“…In Japan, triple therapy with proton-pump inhibitor (PPI), amoxicillin, and clarithromycin is an effective first-line treatment for H. pylori infection in children 13 . In Japan, potassium-competitive acid blocker (P-CAB) may be used instead of PPI in adults 7,14,15 , and P-CAB may be used because of high frequency of CAM-resistance H. pylori, even in adolescents 9,12,16 . To date, H. pylori eradication therapy has no serious side effects in children 9,12,16,17 ; however, there is a need to conduct a long-term evaluation.…”

Gut Microbiota Changes During Helicobacter Pylori Eradication with Vonoprazan-Containing Triple Therapy Among Adolescents: A Prospective Multicenter Study in Japan

“…Considering that the current infection route of H. pylori is person-to-person transmission, particularly within the same family [1], [8], young individuals must take measures against H. pylori infection from the viewpoint of preventing this infection in the next-generation. Based on such circumstances, as a new method of preventing gastric cancer, the screening and treatment of H. pylori infection among young individuals have begun as a primary prevention in Japan [9], [10], [11], [12].…”

“…In Japan, triple therapy with potassium-competitive acid blocker (P-CAB), amoxicillin, and clarithromycin is an effective rst-line treatment for H. pylori infection in adults [13,14] and children [9,12]. To date, H. pylori eradication therapy has no serious side effects in children [9], [15].…”