European Registry on Helicobacter pylori management (Hp-EuReg): patterns and trends in first-line empirical eradication prescription and outcomes of 5 years and 21 533 patients - Inserm - Institut national de la santé et de la recherche médicale Accéder directement au contenu
Article Dans Une Revue Gut Année : 2020

European Registry on Helicobacter pylori management (Hp-EuReg): patterns and trends in first-line empirical eradication prescription and outcomes of 5 years and 21 533 patients

1 UAM - Universidad Autónoma de Madrid
2 AS Loginov Moscow Clinical Scientific Center [Moscow, Russian Federation]
3 A.I. Yevdokimov Moscow State University of Medicine and Dentistry [Moscow, Russian Federation]
4 AM DC Rogaska [Rogaska Slatina, Slovenia]
5 Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC)
6 UNIBO - Alma Mater Studiorum Università di Bologna = University of Bologna
7 UPV/EHU - Universidad del Pais Vasco / Euskal Herriko Unibertsitatea [Espagne]
8 CIBERehd - Centro de Investigación Biomédica en Red en el Área temática de Enfermedades Hepáticas y Digestivas
9 Østfold Hospital
10 LU - University of Latvia
11 Universidad de Oviedo [Oviedo]
12 Henry Dunant Hospital [Athens, Greece]
13 LSMU - Lithuanian University of health Sciences
14 Hospital Universitario HM Sanchinarro [Madrid, Spain]
15 Unicatt - Università cattolica del Sacro Cuore = Catholic University of the Sacred Heart [Roma]
16 Faculty of Medicine [Hacettepe University]
17 LGI - Leeds General Infirmary
18 Ferencváros Health Centre [Budapest, Hungary]
19 FMUP - Faculdade de Medicina da Universidade do Porto
20 TAU - Tel Aviv University
21 Medical University of Sofia [Bulgarie]
22 Timisoara Hospital [Timisoara, Romania]
23 Centre Hospitalier Universitaire de Charleroi
24 University of Split
25 Medical Centre for Postgraduate Education [Warsaw, Poland]
26 University Hospital Basel [Basel]
27 OVGU - Otto-von-Guericke-Universität Magdeburg = Otto-von-Guericke University [Magdeburg]
28 Copenhagen University Hospital
29 Meander Medical Center [Amersfoort, Netherlands]
30 University of Belgrade [Belgrade]
31 Herttoniemi Hospital [Helsinki, Finland]
32 San Pedro de Alcantara Hospital [Cáceres, Espagne]
33 Gastrocentr [Perm, Russian Federation]
34 Digestive Ukrainian Academy of Medical Sciences [Kyiv, Ukraine]
35 Hospital Clínico Universitario “Lozano Blesa” [Zaragoza, Spain]
36 Althaia Xarxa Assistencial Universitària de Manresa [Manresa, Spain]
37 UVicUCC - Universitat de Vic-Universitat Central de Catalunya [Manresa, Spain]
38 CHUS - Complejo Hospitalario Universitario de Santiago de Compostela [Saint-Jacques-de-Compostelle, Espagne]
39 Centre Hospitalier Annecy-Genevois [Saint-Julien-en-Genevois]
40 Physiopathologie du cancer du foie
41 Hôpital Pellegrin
42 Trinity College Dublin
Olga Nyssen
Frode Lerang
  • Fonction : Auteur
Marcis Leja
  • Fonction : Auteur
Yaron Niv
  • Fonction : Auteur
Ante Tonkic
  • Fonction : Auteur
Giulia Fiorini

Résumé

Objective: The best approach for Helicobacter pylori management remains unclear. An audit process is essential to ensure clinical practice is aligned with best standards of care. Design: International multicentre prospective non-interventional registry starting in 2013 aimed to evaluate the decisions and outcomes in H. pylori management by European gastroenterologists. Patients were registered in an e-CRF by AEG-REDCap. Variables included demographics, previous eradication attempts, prescribed treatment, adverse events and outcomes. Data monitoring was performed to ensure data quality. Time-trend and geographical analyses were performed. Results: 30 394 patients from 27 European countries were evaluated and 21 533 (78%) first-line empirical H. pylori treatments were included for analysis. Pretreatment resistance rates were 23% to clarithromycin, 32% to metronidazole and 13% to both. Triple therapy with amoxicillin and clarithromycin was most commonly prescribed (39%), achieving 81.5% modified intention-to-treat eradication rate. Over 90% eradication was obtained only with 10-day bismuth quadruple or 14-day concomitant treatments. Longer treatment duration, higher acid inhibition and compliance were associated with higher eradication rates. Time-trend analysis showed a region-dependent shift in prescriptions including abandoning triple therapies, using higher acid-inhibition and longer treatments, which was associated with an overall effectiveness increase (84%-90%). Conclusion: Management of H. pylori infection by European gastroenterologists is heterogeneous, suboptimal and discrepant with current recommendations. Only quadruple therapies lasting at least 10 days are able to achieve over 90% eradication rates. European recommendations are being slowly and heterogeneously incorporated into routine clinical practice, which was associated with a corresponding increase in effectiveness.

Dates et versions

inserm-02996928 , version 1 (09-11-2020)

Identifiants

Citer

Olga Nyssen, Dmitry Bordin, Bojan Tepes, Ángeles Pérez-Aisa, Dino Vaira, et al.. European Registry on Helicobacter pylori management (Hp-EuReg): patterns and trends in first-line empirical eradication prescription and outcomes of 5 years and 21 533 patients. Gut, 2020, pp.gutjnl-2020-321372. ⟨10.1136/gutjnl-2020-321372⟩. ⟨inserm-02996928⟩

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