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TIME TRENDS AND EFFECTIVENESS OF BISMUTH TREATMENT FOR HELICOBACTER PYLORI INFECTION: RESULTS FROM THE EUROPEAN REGISTRY ON HELICOBACTER PYLORI MANAGEMENT (HP-EUREG) DURING 2013-2021
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Year of publication | 2023 |
Type | Conference abstract |
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Description | Contact E-Mail Address: drapereza@hotmail.com Introduction: Bismuth quadruple therapy (BQT) including bismuth, a proton pump inhibitor (PPI) and two antibiotics has been shown to be a very effective treatment for Helicobacter pylori infection even in areas of high bacterial antibiotic resistance. Bismuth prescriptions seem to be increasing in recent years. Aims & Methods: To describe the use, effectiveness, and safety of BQT in Europe and the evolution of prescriptions as part of the European Registry on Helicobacter pylori management (Hp-EuReg). All patients who had received BQT in a 9-year period were included. The thirty-one countries participating in the Hp-EuReg been clustered in previous studies in five main regions based both on their geographical situation and the gross domestic product per capita (North, Centre, Est, South-Est, South-West). Data on the prescribed schedules, previous eradication attempts, effectiveness and the incidence of adverse events was analysed. A time trend analysis of the different BQT treatment prescriptions was likewise performed. Effectiveness was defined by a modified intention-totreat (mITT) analysis. A multivariate analysis was performed to determine the variables predicting treatment effectiveness. Results: Of the 49,690 patients included in the Hp-EuReg, 15,582 (31%) had received BQT. BQT use increased from 8.6% to 39% during the study period. Forty-six different schedules were used, of which 8 were administered to more than 100 patients. Single-capsule BQT (ScBQT) containing bismuth, metronidazole and tetracycline plus a PPI was the most used therapy (43%). In naive patients, the following BQTs obtained over 90% effectiveness: those using tetracycline and metronidazole, either drugs prescribed separately for 14 days, or as 10-day ScBQT; and those using amoxicillin either with clarithromycin or metronidazole, both for 14 days. ScBQT was the only schedule achieving optimal cure rates in all the geographical areas. Standard- or high-dose PPIs, prescriptions of 10-14 days and the schedule type are significantly related to higher cure rates in the multivariate analysis. |