763cfe6ffaf5931201106204bc725d4a pmc_33375717.pdf a10bb8fd428fbc155ecb0e8c60f7fc35e38774ad pmc_33375717.pdf 8b80d5750e1da63bd09a1be1a9ab2eda0934de9e0781d1d56af02de72a8917ba pmc_33375717.pdf Title: European Registry on Helicobacter pylori Management: Effectiveness of First and Second-Line Treatment in Spain Subject: The management of Helicobacter pylori infection has to rely on previous local effectiveness due to the geographical variability of antibiotic resistance. The aim of this study was to evaluate the effectiveness of first and second-line H. pylori treatment in Spain, where the empirical prescription is recommended. A multicentre prospective non-interventional registry of the clinical practice of European gastroenterologists concerning H. pylori infection (Hp-EuReg) was developed, including patients from 2013 until June 2019. Effectiveness was evaluated descriptively and through a multivariate analysis concerning age, gender, presence of ulcer, proton-pump inhibitor (PPI) dose, therapy duration and compliance. Overall, 53 Spanish hospitals were included, and 10,267 patients received a first-line therapy. The best results were obtained with the 10-day bismuth single-capsule therapy (95% cure rate by intention-to-treat) and with both the 14-day bismuth-clarithromycin quadruple (PPI-bismuth-clarithromycin-amoxicillin, 91%) and the 14-day non-bismuth quadruple concomitant (PPI-clarithromycin-amoxicillin-metronidazole, 92%) therapies. Second-line therapies were prescribed to 2448 patients, with most-effective therapies being the triple quinolone (PPI-amoxicillin-levofloxacin/moxifloxacin) and the bismuth-levofloxacin quadruple schemes (PPI-bismuth-levofloxacin-amoxicillin) prescribed for 14 days (92%, 89% and 90% effectiveness, respectively), and the bismuth single-capsule (10 days, 88.5%). Compliance, longer duration and higher acid inhibition were associated with higher effectiveness. “Optimized” H. pylori therapies achieve over 90% success in Spain. Keywords: Helicobacter pylori; treatment; first-line; second-line; Spain Author: María Caldas, Ángeles Pérez-Aisa, Manuel Castro-Fernández, Luis Bujanda, Alfredo J. Lucendo, Luis Rodrigo, Jose M. Huguet, Jorge Pérez-Lasala, Javier Molina-Infante, Jesús Barrio, Luis Fernández-Salazar, Ángel Lanas, Mónica Perona, Manuel Domínguez-Cajal, Juan Ortuño, Blas José Gómez-Rodríguez, Pedro Almela, Josep María Botargués, Óscar Núñez, Inés Modolell, Judith Gómez, Rafael Ruiz-Zorrilla, Cristóbal De la Coba, Alain Huerta, Eduardo Iyo, Liliana Pozzati, Rosario Antón, Mercé Barenys, Teresa Angueira, Miguel Fernández-Bermejo, Ana Campillo, Javier Alcedo, Ramón Pajares-Villaroya, Marianela Mego, Fernando Bermejo, José Luis Dominguez-Jiménez, Llúcia Titó, Nuria Fernández, Manuel Pabón-Carrasco, Ángel Cosme, Pilar Mata-Romero, Noelia Alcaide, Inés Ariño, Tommaso Di Maira, Ana Garre, Ignasi Puig, Olga P. Nyssen, Francis Megraud, Colm O’Morain, Javier P. Gisbert and on behalf of the Hp-EuReg Investigators Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Tue Dec 29 06:00:53 2020 CET ModDate: Tue Dec 29 06:23:06 2020 CET Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 15 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 931436 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- LTTAGL+VnURWPalladioL Type 1 Custom yes yes no 10 0 ZXLIQL+URWPalladioL-Ital Type 1 Custom yes yes no 15 0 CJMSJG+URWPalladioL-Bold Type 1 Custom yes yes no 20 0 UJLZEY+URWPalladioL-BoldItal Type 1 Custom yes yes no 24 0 MAEYFP+URWPalladioL-Roma Type 1 Custom yes yes no 28 0 QMCQLP+VnURWPalladioL-Bold Type 1 Custom yes yes no 32 0 YYFPCJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 41 0 MCBCCI+SourceSansRoman-Regular Type 1C Custom yes yes no 63 0 MCBCCM+SourceSansRoman.613wght Type 1C Custom yes yes no 67 0 MCBCCO+SourceSansRoman-Bold Type 1C Custom yes yes no 71 0 LVGCAU+CMSY10 Type 1 Builtin yes yes no 86 0 LGIGFO+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 96 0 LGIGFP+PalatinoLinotype CID TrueType Identity-H yes yes yes 99 0 LGIGGA+PalatinoLinotype TrueType WinAnsi yes yes no 105 0 LGIGGC+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 108 0 LGIGFO+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 145 0 LGIGGA+PalatinoLinotype TrueType WinAnsi yes yes no 148 0 LGIGGC+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 151 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-01-31 02:33:38 CET RepresentationInformation: pmc_33375717.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2021-01-25 03:36:35 CET Size: 931436 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 332 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Results Destination: section.2 Children: Item: Title: Baseline Characteristics Destination: subsection.2.1 Item: Title: Treatment Use and Effectiveness Destination: subsection.2.2 Children: Item: Title: First-Line Treatment Destination: subsubsection.2.2.1 Item: Title: Second-Line Treatment Destination: subsubsection.2.2.2 Item: Title: Penicillin Allergic Patients Destination: subsection.2.3 Item: Title: Discussion Destination: section.3 Item: Title: Materials and Methods Destination: section.4 Children: Item: Title: Variables Destination: subsection.4.1 Item: Title: Effectiveness Analysis Destination: subsection.4.2 Item: Title: Statistical Analysis Destination: subsection.4.3 Item: Title: Outcome Reporting Destination: subsection.4.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.5 Info: Title: European Registry on Helicobacter pylori Management: Effectiveness of First and Second-Line Treatment in Spain Author: María Caldas, Ángeles Pérez-Aisa, Manuel Castro-Fernández, Luis Bujanda, Alfredo J. Lucendo, Luis Rodrigo, Jose M. Huguet, Jorge Pérez-Lasala, Javier Molina-Infante, Jesús Barrio, Luis Fernández-Salazar, Ángel Lanas, Mónica Perona, Manuel Domínguez-Cajal, Juan Ortuño, Blas José Gómez-Rodríguez, Pedro Almela, Josep María Botargués, Óscar Núñez, Inés Modolell, Judith Gómez, Rafael Ruiz-Zorrilla, Cristóbal De la Coba, Alain Huerta, Eduardo Iyo, Liliana Pozzati, Rosario Antón, Mercé Barenys, Teresa Angueira, Miguel Fernández-Bermejo, Ana Campillo, Javier Alcedo, Ramón Pajares-Villaroya, Marianela Mego, Fernando Bermejo, José Luis Dominguez-Jiménez, Llúcia Titó, Nuria Fernández, Manuel Pabón-Carrasco, Ángel Cosme, Pilar Mata-Romero, Noelia Alcaide, Inés Ariño, Tommaso Di Maira, Ana Garre, Ignasi Puig, Olga P. Nyssen, Francis Megraud, Colm O’Morain, Javier P. Gisbert and on behalf of the Hp-EuReg Investigators Subject: The management of Helicobacter pylori infection has to rely on previous local effectiveness due to the geographical variability of antibiotic resistance. The aim of this study was to evaluate the effectiveness of first and second-line H. pylori treatment in Spain, where the empirical prescription is recommended. A multicentre prospective non-interventional registry of the clinical practice of European gastroenterologists concerning H. pylori infection (Hp-EuReg) was developed, including patients from 2013 until June 2019. Effectiveness was evaluated descriptively and through a multivariate analysis concerning age, gender, presence of ulcer, proton-pump inhibitor (PPI) dose, therapy duration and compliance. Overall, 53 Spanish hospitals were included, and 10,267 patients received a first-line therapy. The best results were obtained with the 10-day bismuth single-capsule therapy (95% cure rate by intention-to-treat) and with both the 14-day bismuth-clarithromycin quadruple (PPI-bismuth-clarithromycin-amoxicillin, 91%) and the 14-day non-bismuth quadruple concomitant (PPI-clarithromycin-amoxicillin-metronidazole, 92%) therapies. Second-line therapies were prescribed to 2448 patients, with most-effective therapies being the triple quinolone (PPI-amoxicillin-levofloxacin/moxifloxacin) and the bismuth-levofloxacin quadruple schemes (PPI-bismuth-levofloxacin-amoxicillin) prescribed for 14 days (92%, 89% and 90% effectiveness, respectively), and the bismuth single-capsule (10 days, 88.5%). Compliance, longer duration and higher acid inhibition were associated with higher effectiveness. “Optimized” H. pylori therapies achieve over 90% success in Spain. 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