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Effectiveness and Safety of High-Dose Dual Therapy: Results of the European Registry on the Management of Helicobacter pylori Infection (Hp-EuReg)

Background: Randomized clinical trials and meta-analyses, primarily from Asian countries, have reported good effectiveness with high-dose dual therapy (HDDT) including a proton pump inhibitor (PPI) and amoxicillin when prescribed as H. pylori first-line or rescue treatment. However, combining amoxic...

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Autores principales: Fernández-Salazar, Luis, Campillo, Ana, Rodrigo, Luis, Pérez-Aisa, Ángeles, González-Santiago, Jesús M., Segarra Ortega, Xavier, Denkovski, Maja, Brglez Jurecic, Natasa, Bujanda, Luis, Gómez Rodríguez, Blas José, Ortuño, Juan, Georgopoulos, Sotirios, Jonaitis, Laimas, Puig, Ignasi, Nyssen, Olga P., Megraud, Francis, O’Morain, Colm, Gisbert, Javier P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9225562/
https://www.ncbi.nlm.nih.gov/pubmed/35743627
http://dx.doi.org/10.3390/jcm11123544
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author Fernández-Salazar, Luis
Campillo, Ana
Rodrigo, Luis
Pérez-Aisa, Ángeles
González-Santiago, Jesús M.
Segarra Ortega, Xavier
Denkovski, Maja
Brglez Jurecic, Natasa
Bujanda, Luis
Gómez Rodríguez, Blas José
Ortuño, Juan
Georgopoulos, Sotirios
Jonaitis, Laimas
Puig, Ignasi
Nyssen, Olga P.
Megraud, Francis
O’Morain, Colm
Gisbert, Javier P.
author_facet Fernández-Salazar, Luis
Campillo, Ana
Rodrigo, Luis
Pérez-Aisa, Ángeles
González-Santiago, Jesús M.
Segarra Ortega, Xavier
Denkovski, Maja
Brglez Jurecic, Natasa
Bujanda, Luis
Gómez Rodríguez, Blas José
Ortuño, Juan
Georgopoulos, Sotirios
Jonaitis, Laimas
Puig, Ignasi
Nyssen, Olga P.
Megraud, Francis
O’Morain, Colm
Gisbert, Javier P.
author_sort Fernández-Salazar, Luis
collection PubMed
description Background: Randomized clinical trials and meta-analyses, primarily from Asian countries, have reported good effectiveness with high-dose dual therapy (HDDT) including a proton pump inhibitor (PPI) and amoxicillin when prescribed as H. pylori first-line or rescue treatment. However, combining amoxicillin with PPIs in the 1990s in several European countries yielded suboptimal results. Methods: An international, multicenter, prospective non-interventional Registry (Hp-EuReg) aimed to evaluate the decisions and outcomes of H. pylori management by European gastroenterologists. All infected adult cases treated with HDDT were registered at e-CRF AEG-REDCap platform until June 2021. Sixty patients were prescribed with HDDT (98% compliance), 19 of them received a first-line therapy and 41 a rescue treatment (second- to sixth-line). Results: Overall HDDT effectiveness was 52% (per-protocol) and 51% (modified intention-to-treat). First-line and rescue treatment lines were equally effective, but the effectiveness was worse when patients had previously received metronidazole, tetracycline, or rifabutin. Adding bismuth to HDDT in rescue treatment did not yield better results. The incidence of adverse events was 30%, diarrhea being the most common (20% of patients); no serious adverse events were reported. Conclusion: Although HDDT is safe and has good compliance, it is not a good option in European first-line or rescue H. pylori treatment, even when adding bismuth.
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spelling pubmed-92255622022-06-24 Effectiveness and Safety of High-Dose Dual Therapy: Results of the European Registry on the Management of Helicobacter pylori Infection (Hp-EuReg) Fernández-Salazar, Luis Campillo, Ana Rodrigo, Luis Pérez-Aisa, Ángeles González-Santiago, Jesús M. Segarra Ortega, Xavier Denkovski, Maja Brglez Jurecic, Natasa Bujanda, Luis Gómez Rodríguez, Blas José Ortuño, Juan Georgopoulos, Sotirios Jonaitis, Laimas Puig, Ignasi Nyssen, Olga P. Megraud, Francis O’Morain, Colm Gisbert, Javier P. J Clin Med Article Background: Randomized clinical trials and meta-analyses, primarily from Asian countries, have reported good effectiveness with high-dose dual therapy (HDDT) including a proton pump inhibitor (PPI) and amoxicillin when prescribed as H. pylori first-line or rescue treatment. However, combining amoxicillin with PPIs in the 1990s in several European countries yielded suboptimal results. Methods: An international, multicenter, prospective non-interventional Registry (Hp-EuReg) aimed to evaluate the decisions and outcomes of H. pylori management by European gastroenterologists. All infected adult cases treated with HDDT were registered at e-CRF AEG-REDCap platform until June 2021. Sixty patients were prescribed with HDDT (98% compliance), 19 of them received a first-line therapy and 41 a rescue treatment (second- to sixth-line). Results: Overall HDDT effectiveness was 52% (per-protocol) and 51% (modified intention-to-treat). First-line and rescue treatment lines were equally effective, but the effectiveness was worse when patients had previously received metronidazole, tetracycline, or rifabutin. Adding bismuth to HDDT in rescue treatment did not yield better results. The incidence of adverse events was 30%, diarrhea being the most common (20% of patients); no serious adverse events were reported. Conclusion: Although HDDT is safe and has good compliance, it is not a good option in European first-line or rescue H. pylori treatment, even when adding bismuth. MDPI 2022-06-20 /pmc/articles/PMC9225562/ /pubmed/35743627 http://dx.doi.org/10.3390/jcm11123544 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Fernández-Salazar, Luis
Campillo, Ana
Rodrigo, Luis
Pérez-Aisa, Ángeles
González-Santiago, Jesús M.
Segarra Ortega, Xavier
Denkovski, Maja
Brglez Jurecic, Natasa
Bujanda, Luis
Gómez Rodríguez, Blas José
Ortuño, Juan
Georgopoulos, Sotirios
Jonaitis, Laimas
Puig, Ignasi
Nyssen, Olga P.
Megraud, Francis
O’Morain, Colm
Gisbert, Javier P.
Effectiveness and Safety of High-Dose Dual Therapy: Results of the European Registry on the Management of Helicobacter pylori Infection (Hp-EuReg)
title Effectiveness and Safety of High-Dose Dual Therapy: Results of the European Registry on the Management of Helicobacter pylori Infection (Hp-EuReg)
title_full Effectiveness and Safety of High-Dose Dual Therapy: Results of the European Registry on the Management of Helicobacter pylori Infection (Hp-EuReg)
title_fullStr Effectiveness and Safety of High-Dose Dual Therapy: Results of the European Registry on the Management of Helicobacter pylori Infection (Hp-EuReg)
title_full_unstemmed Effectiveness and Safety of High-Dose Dual Therapy: Results of the European Registry on the Management of Helicobacter pylori Infection (Hp-EuReg)
title_short Effectiveness and Safety of High-Dose Dual Therapy: Results of the European Registry on the Management of Helicobacter pylori Infection (Hp-EuReg)
title_sort effectiveness and safety of high-dose dual therapy: results of the european registry on the management of helicobacter pylori infection (hp-eureg)
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9225562/
https://www.ncbi.nlm.nih.gov/pubmed/35743627
http://dx.doi.org/10.3390/jcm11123544
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