Helicobacter最新文献

{"title":"Effect of Macrolide Exposure on Tailored Helicobacter pylori Eradication Therapy and Antibiotic Resistance Profiles: A Prospective Study Using the Drug Utilization Review System","authors":"Jin Hee Noh,&nbsp;Kee Don Choi,&nbsp;Hee Kyong Na,&nbsp;Ji Yong Ahn,&nbsp;Jeong Hoon Lee,&nbsp;Kee Wook Jung,&nbsp;Do Hoon Kim,&nbsp;Ho June Song,&nbsp;Gin Hyug Lee,&nbsp;Hwoon-Yong Jung","doi":"10.1111/hel.70003","DOIUrl":"https://doi.org/10.1111/hel.70003","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background/Aims</h3>\u0000 \u0000 <p>Determining antibiotic use history accurately is challenging due to its reliance on patient recall. By determining macrolide exposure using the Korean drug utilization review (DUR) system, we analyzed the impact of previous macrolide use on antibiotic resistance profiles and compared the eradication rate between tailored therapy based on macrolide exposure history and empirical therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with confirmed <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection who agreed to access prescription information using the Health Insurance Review and Assessment Service DUR system were enrolled between 2021 and 2023. Patients received tailored therapy, which was clarithromycin (CLR)-based triple therapy in cases without macrolide exposure and bismuth quadruple (BQ) therapy in cases with macrolide exposure. The empirical therapy group was prospectively recruited at the same time to compare the eradication rate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 418 patients (tailored therapy group, <i>n</i> = 57; empirical therapy group, <i>n</i> = 361) were analyzed. Among the tailored therapy group, 24.6% took macrolide antibiotics for the past 5 years. CLR resistance rates were higher in patients with previous macrolide use than in those without (66.7% vs. 7.5%, <i>p</i> &lt; 0.001). The tailored therapy group showed a higher eradication rate than the empirical therapy group for intention-to-treat (ITT), modified intention-to-treat (MITT), and per-protocol (PP) analyses (ITT, 86.0% vs. 75.6%; MITT, 94.2% vs. 80.3%; PP, 94.2% vs. 85.1%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Previous macrolide exposure identified using the DUR system was associated with a higher rate of CLR resistance. Tailored therapy based on macrolide exposure history led to higher eradication rates compared to empirical therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142764097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Helicobacter pylori Infection in Children: To Eradicate or Not to Eradicate?","authors":"Marco Manfredi,&nbsp;Madhur Ravikumara","doi":"10.1111/hel.70002","DOIUrl":"https://doi.org/10.1111/hel.70002","url":null,"abstract":"<div>\u0000 \u0000 <p><i>Helicobacter pylori</i> infection is usually acquired during childhood and represents one of the most common infections in humans. It is well known that <i>H. pylori</i> has belonged to humankind for hundreds of thousands of years and it accompanied the human migration from Africa. The adult international guidelines recommend treating all infected patients as <i>H. pylori</i> was classified among the first-class human carcinogens by the WHO in 1994 and it is one of the main factors involved in the development of gastric cancer. Conversely, the pediatric international guidelines are more restrictive in recommending the eradication of the infection in children. Although many studies have shown evidence regarding the pathological role of <i>H. pylori</i> regardless of the age of the infected patients, many others have highlighted its protective/positive role in several extra-gastric diseases in children. In this review, both points of view regarding the eradication in children are critically analyzed.</p>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142685296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Helicobacter pylori Eradication Therapy and the Risk of Colorectal Cancer: A Population-Based Nationwide Cohort Study in Sweden","authors":"Qing Liu,&nbsp;Omid Sadr-Azodi,&nbsp;Lars Engstrand,&nbsp;Katja Fall,&nbsp;Nele Brusselaers","doi":"10.1111/hel.70001","DOIUrl":"https://doi.org/10.1111/hel.70001","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p><i>Helicobacter pylori</i> (<i>H. pylori</i>) is an established gastric carcinogen, also associated with an increased risk of colorectal cancer. Therefore, we suspected that <i>H. pylori</i> eradication lowers the risk of colorectal cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>We assessed if <i>H. pylori</i> eradication therapy is associated with a reduced risk of colorectal adenocarcinoma in a population-based nationwide cohort study. This study included all Swedish adults with at least one recorded <i>H. pylori</i> eradication episode between July 2005 and December 2012, based on the high-quality Swedish health registries. Colorectal adenocarcinoma risks were compared to the Swedish background population, presented as standardized incidence ratios (SIRs) and 95% confidence intervals (CIs), accounting for age, sex, calendar period, tumor location (left or right sided), stage, and number of eradication episodes, from 1 year after eradication and onward.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 80,381 individuals receiving <i>H. pylori</i> eradication therapy (average follow-up 4.1 years), 282 were diagnosed with colorectal cancer (97.2% adenocarcinoma). Overall, <i>H. pylori</i> eradication was associated with an elevated risk of colorectal adenocarcinoma (SIR 1.27, 95% CI: 1.12–1.43). The colorectal adenocarcinoma risk was increased 1–2 years after eradication (SIR 1.42, 95% CI: 1.17–1.72), then decreased 2–4 years (SIR 0.80, 95% CI: 0.65–0.98) and 4–6 years (SIR 0.76, 95% CI: 0.57–0.99), yet not ≥ 6 years (SIR 1.36, 95% CI: 0.78–2.21) after eradication compared to the general population. Overall, right-sided (SIR 1.47, 95% CI: 1.21–1.76) and left-sided (SIR 1.35, 95% CI: 1.09–1.67) colon adenocarcinomas risks were higher among eradicated individuals than the general population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p><i>H. pylori</i> eradication was not associated with a clear and consistent reduction of colorectal cancer in our Swedish cohort.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.70001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142674230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LCI's Diagnostic Performance for Gastric Cancer: A New Solution to Screening?","authors":"Guilherme Nobre Nogueira","doi":"10.1111/hel.70000","DOIUrl":"10.1111/hel.70000","url":null,"abstract":"","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nationwide Trends in Helicobacter pylori Eradication Therapies in Korea: Impact of Guideline Updates on Treatment Practices","authors":"Byung Wook Jung,&nbsp;Yun Jin Kim,&nbsp;Chan Hyuk Park","doi":"10.1111/hel.13152","DOIUrl":"10.1111/hel.13152","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p><i>Helicobacter pylori</i> infects over 50% of the global population, prompting the issuance of guidelines for effective diagnosis and treatment. However, research on guideline dissemination and adherence is limited. Therefore, we assessed the nationwide status of <i>H. pylori</i> eradication therapies in Korea before and after guideline updates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using data from the Korean National Health Insurance Service, this retrospective cohort study analyzed changes in <i>H. pylori</i> eradication therapies across three periods: Phase I (2006–2007), Phase II (2014–2015), and Phase III (2021–2022). It examined therapy regimens, confirmation tests, and retreatment rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 1,657,746 patients included, the number undergoing eradication therapy increased across the phases (Phase I: 234,365; Phase II: 493,889; Phase III: 929,492). The use of conventional triple therapy declined from 96.1% in Phase I to 88.3% in Phase III, while non-bismuth and bismuth quadruple therapies increased to 6.8% and 3.3%, respectively, in Phase III. The proportion of patients following a 1-week regimen of conventional triple therapy decreased from 90.3% in Phase I to 54.2% in Phase III, while a 2-week regimen increased to 36.1% in Phase III. Confirmation testing within 1 year of therapy increased from 21.3% in Phase I to 43.0% in Phase III, whereas retreatment rates increased from 3.8% in Phase I to 8.8% in Phase III.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Guideline updates have influenced <i>H. pylori</i> eradication practices in Korea, leading to increased use of quadruple therapies with longer treatment durations. However, further improvements in confirmatory tests and retreatment following failed initial therapy are required.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Helicobacter pylori Management in Africa: A Survey of Diagnostic, Treatment, and Related Resources","authors":"Setshedi Mashiko,&nbsp;Stella Ifeanyi Smith,&nbsp;Ugiagbe Rose,&nbsp;Otegbayo Jesse Abiodun,&nbsp;Hyasinta Jaka,&nbsp;Onyekwere Charles,&nbsp;Nashidengo Abdulrashid,&nbsp;Kayamba Violet,&nbsp;Tshibangu-Kabamba Evariste,&nbsp;Ndububa Dennis,&nbsp;Gunturu Revathi,&nbsp;Lahbabi-Amrani Naima,&nbsp;Ajayi Abraham,&nbsp;Tolulope Funbi Jolaiya,&nbsp;Dieye Yakhya,&nbsp;Alboraie Mohamed,&nbsp;Ndip Roland","doi":"10.1111/hel.13153","DOIUrl":"10.1111/hel.13153","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although <i>Helicobacter pylori</i> infection (<i>H. pylori</i>) prevalence in Africa has declined in the last decade, it remains concerningly high. <i>H. pylori</i> is asymptomatic in the majority of patients but is associated with significant morbidity and mortality in 10%–20%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We conducted an online survey of 21 African countries, with the link distributed to members of the African Helicobacter Microbiota Study Group. The survey was completed by 562 respondents; the majority were from Nigeria (27.2%), South Africa (18.1%), Tanzania (17.6%), Egypt (16.9%), and Cameroon (14.2%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The most common reason for <i>H. pylori</i> testing was dyspepsia in 83.9% of the cases. Abnormal findings at gastroscopy (62.3%) and heartburn (61.7%) were also common indications. Stool antigen testing and histological examination of gastric biopsies using Giemsa were the two most used methods for <i>H. pylori</i> testing at 62.3% and 50.3%, respectively. Most respondents reported the use of standard clarithromycin-based triple therapy as first-line treatment for <i>H. pylori</i> infection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This survey has demonstrated the diversity of practice and resource availability within the African continent. Several international guidelines exist on the management of <i>H. pylori</i>, but little data is available in Africa on how this condition is managed in every day clinical practice. There is an urgent need to formulate evidence-based and locally relevant practice guidelines on the African continent. In this context, the African Helicobacter and Microbiota study group was formed to coordinate efforts across the continent on <i>H. pylori</i> research to provide guidance on its management. This paper, therefore, aimed to evaluate the practice of <i>H. pylori</i> diagnostics and management, as well as related resources in representative countries in Africa, to facilitate the development of such guidelines.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Vonoprazan in Dual/Triple/Quadruple Regimens Both in First-Line and Rescue Therapy for Helicobacter pylori Eradication: A Systematic Review With Meta-Analysis","authors":"Belén Martínez Benito,&nbsp;Olga P. Nyssen,&nbsp;Javier P. Gisbert","doi":"10.1111/hel.13148","DOIUrl":"10.1111/hel.13148","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The efficacy of <i>Helicobacter pylori</i> (<i>H. pylori</i>) eradication therapies encompassing one or more antibiotics and a proton pump inhibitor (PPI) has lately decreased. Vonoprazan (VPZ), a potassium-competitive acid blocker, provides higher gastric acid suppression than PPIs. We performed a meta-analysis evaluating the efficacy and safety of VPZ in <i>H. pylori</i> eradication therapies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Studies were searched in PubMed, Embase, and the Cochrane Library up to June 2023. Efficacy was evaluated by intention-to-treat analysis. Data were combined by meta-analyzing risk differences (RD). Heterogeneity was evaluated by subgrouping.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventy-seven studies (24 randomized clinical trials) evaluated 44,162 patients (22,297 receiving VPZ and 21,865 PPIs). Overall VPZ efficacy was 88% (95% CI = 87%–90%): 86%, 88%, and 94% for dual/triple/quadruple-VPZ-containing therapies. VPZ efficacy was 87% (86%–89%) in first-line and 90% (87%–93%) in rescue therapy. VPZ performed better than PPIs in treatment-naïve patients (87% vs. 70%; RD = 0.13, 95% CI = 0.11–0.15) and when using triple regimens. No significant differences were observed in rescue and quadruple therapies. In patients with clarithromycin-resistant infection, VPZ-based therapies demonstrated an 81% efficacy (76%–85%), surpassing PPIs (76% vs. 40%; RD = 0.33, 95% CI = 0.24–0.43). For clarithromycin-susceptible strains, VPZ efficacy was 92% (89%–95%), similar to PPIs. VPZ adverse events rate was 19% (16%–21%), comparable to PPI-based regimens (18% vs. 13%, respectively; RD = 0.00, 95% CI = −0.01 to 0.02, <i>p</i> = 0.57).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The efficacy of VPZ-based regimens was over 85% in all treatment combinations. In treatment-naïve and clarithromycin-resistant patients, VPZ performed better than PPIs. In rescue therapy, in clarithromycin-susceptible patients or when quadruple regimens were prescribed, this advantage was not confirmed. Tolerability was similar in both regimens.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tegoprazan-Amoxicillin Dual Therapy for Helicobacter pylori Eradication: A Prospective, Randomized, Multicenter Study in Fujian, China","authors":"Xueyan Lin,&nbsp;Huping Huang,&nbsp;Yijuan Liu,&nbsp;Yanling Zeng,&nbsp;Shiyun Lu,&nbsp;Xuefeng Xu,&nbsp;Yun Lin,&nbsp;Feng Qiu,&nbsp;Fangfang Cai,&nbsp;Jie Pan,&nbsp;Shaozhong Huang,&nbsp;Shaowei Lin,&nbsp;Aiping Lin,&nbsp;Zhihui Lin,&nbsp;Xueping Huang","doi":"10.1111/hel.13151","DOIUrl":"10.1111/hel.13151","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Few studies have investigated the efficacy and safety of tegoprazan-amoxicillin (TA) dual therapy for &lt;i&gt;Helicobacter pylori&lt;/i&gt; eradication. We aim to evaluate the effectiveness and safety of different dosages of TA dual therapy for &lt;i&gt;H. pylori&lt;/i&gt; eradication.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This prospective, randomized, open-label, multicenter study was conducted at four centers in Fujian, China. &lt;i&gt;H. pylori-&lt;/i&gt;infective patients were randomized 1:1:1 to receive one of the following treatments: bismuth quadruple therapy (BQT, esomeprazole 20 mg twice daily + potassium bismuth citrate 240 mg twice daily + amoxicillin 1 g twice daily + clarithromycin 500 mg twice daily), tegoprazan-amoxicillin dual therapies (TA-qd, tegoprazan 50 mg once daily + amoxicillin 1 g thrice daily; TA-bid, tegoprazan 50 mg twice daily + amoxicillin 1 g thrice daily) for 14 days. The primary outcome was noninferiority in eradication rates of the different TA groups compared to the BQT group. Secondary outcomes encompassed an assessment of adverse reactions and clinical symptom relief. Additionally, exploratory outcomes were focused on the shifts in gut microbiota and a cost-effectiveness analysis.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A total of 321 patients were enrolled. The eradication rates in the BQT group, TA-qd group, and TA-bid group were 85.05% (91/107), 85.98% (92/107), and 85.98% (92/107) in the intention-to-treat analysis (ITT) (BQT vs. TA-qd, 95% CI −8.50% to 10.36%, noninferiority &lt;i&gt;p&lt;/i&gt; = 0.012; BQT vs. TA-bid, 95% CI −8.50% to 10.36%, noninferiority &lt;i&gt;p&lt;/i&gt; = 0.012); 91.00% (91/100), 91.09% (92/101), and 92.93% (92/99) in the modified intention-to-treat analysis (mITT) (BQT vs. TA-qd, 95% CI −7.81% to 7.98%, noninferiority &lt;i&gt;p&lt;/i&gt; = 0.006; BQT vs. TA-bid, 95% CI −5.62% to 9.48%, noninferiority &lt;i&gt;p&lt;/i&gt; &lt; 0.001); 90.81% (89/98), 91.00% (91/100), and 93.81% (91/97) in the per-protocol analysis (PP) (BQT vs. TA-qd, 95% CI −7.83% to 8.19%, noninferiority &lt;i&gt;p&lt;/i&gt; = 0.006; BQT vs. TA-bid, 95% CI 4.46% to 10.46%, noninferiority &lt;i&gt;p&lt;/i&gt; &lt; 0.001). The incidence of adverse reactions in the TA-qd and TA-bid groups was significantly lower than in the BQT group (13.33%, 14.56%, and 27.18%, respectively; &lt;i&gt;p&lt;/i&gt; = 0.017). The complete remissions of clinical symptoms for BQT, TA-qd, and TA-bid were 36.89%, 65.71%, and 68.93%, respectively, had significant differences (&lt;i&gt;p&lt;/i&gt; &lt; 0.001). Two weeks of TA therapy altered gut microbiota diversity and composition, but that recovered 4 weeks after discontinuation. The cost-effectiveness ratios (CERs) for BQT, TA-qd, and TA-bid were 1.85 CNY, 2.08 CNY, and 3.69 CNY, respectively.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 ","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Efficacy and Safety of Potassium-Competitive Acid Blockers and Proton Pump Inhibitors for First-Line Helicobacter pylori Eradication Therapy: A Systematic Review and Network Meta-Analysis","authors":"Mengling Ouyang,&nbsp;Shupeng Zou,&nbsp;Qian Cheng,&nbsp;Xuan Shi,&nbsp;Minghui Sun","doi":"10.1111/hel.13150","DOIUrl":"10.1111/hel.13150","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Given the increasing antibiotic resistance and the inadequate acid-suppressing effects of proton pump inhibitors (PPIs), it is crucial to continuously optimize existing <i>Helicobacter pylori</i> (<i>H. pylori</i>) treatment regimens. This study aimed to evaluate the clinical efficacy and safety of novel potassium-competitive acid blocker (P-CAB)-based eradication regimens compared with traditional PPI-based regimens for the initial treatment of <i>H. pylori</i>.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We conducted a systematic review and network meta-analysis, searching seven electronic databases for randomized controlled trials (RCTs) evaluating initial P-CAB-based <i>H. pylori</i> eradication therapy. The primary outcome was the <i>H. pylori</i> eradication rate. Secondary outcomes included adverse events and patient compliance. We synthesized the effect sizes of the trials using odds ratios (OR) and 95% confidence intervals (95% CI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 54 RCTs involving 15,320 patients (74.9% male, mean age 30.2 years) were included in this study. In the intention-to-treat (ITT) analysis, VPZ-HD-dual, VPZ-triple, and VPZ-quadruple regimens demonstrated significantly higher eradication rates than PPI-triple, PPI-quadruple, and VPZ-dual regimens. Similar trends were observed in the per-protocol (PP) analysis. Subgroup analysis indicated that poor patient compliance significantly reduced eradication rates. Resistance to clarithromycin and metronidazole significantly weakened the eradication effects of PPI-triple, TPZ-triple, and VPZ-triple regimens. Additionally, the eradication rates for 7-day regimens were significantly lower than those for 14-day or 10-day regimens, but there was no significant difference between the eradication rates of 10-day and 14-day regimens. Notably, the risk of adverse events with VPZ-HD-dual was significantly lower than with VPZ-quadruple.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Vonoprazan combined with high-dose amoxicillin dual therapy not only provides satisfactory eradication rates but also exhibits lower adverse event rates and good patient compliance, indicating its potential as a promising regimen for further promotion.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Bismuth Quadruple Therapy in the Treatment of Helicobacter pylori-Infected Peptic Ulcer Children in Vietnam","authors":"Thi Minh Phuong Do,&nbsp;Thi Huyen Trang Tran,&nbsp;Van Tinh Nguyen,&nbsp;Thi Phuong Mai Chu,&nbsp;Loi Nguyen,&nbsp;Kim Thanh Nguyen,&nbsp;Thi Bich Ngoc Hoang,&nbsp;Anh Le Huu Phuong,&nbsp;Yoshio Yamaoka,&nbsp;Linus Olson,&nbsp;Thi Viet Ha Nguyen","doi":"10.1111/hel.13149","DOIUrl":"10.1111/hel.13149","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The continuous increase in drug-resistant strains, the lack of novel antibiotics, and the fewer options available to combat antibiotic-resistant infections in pediatrics pose significant challenges to the eradication of <i>Helicobacter pylori (H. pylori)</i> in children. This study evaluated the efficacy of first-line therapy with bismuth quadruple therapy in <i>H. pylori</i>-positive pediatric patients with peptic ulcers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>136 patients (aged between 8 and 17 years) diagnosed with active peptic ulcers with <i>H. pylori</i> infection were enrolled in this study. Patients with <i>H. pylori</i> strain sensitive to tetracycline and metronidazole were assigned to bismuth quadruple therapy, including a proton pump inhibitor (PPI), bismuth, tetracycline, and metronidazole. Antibiotic resistance of <i>H. pylori</i> was analyzed by the Epsilometer test. Treatment efficacy was evaluated at 12 weeks based on <i>H. pylori</i> eradication and peptic ulcer healing rates. <i>H. pylori</i> infection status was evaluated by a ¹³C-urea breath test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Most isolates showed extremely high rates of resistance to commonly prescribed antibiotics used for children, including clarithromycin (97.0%) and amoxicillin (84.6%), while the low rate of resistance to levofloxacin (16.2%). The overall success rate of eradication therapy in the intention-to-treat and the per-protocol group were 86.0% and 89.3%, respectively. Peptic ulcer healing rates for total patients at 6 weeks and 12 weeks were 75.0% and 97.7%, respectively. There were no entail unpleasant adverse events, and peptic ulcer symptoms decreased steadily over time in all cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The bismuth quadruple therapy with a 2-week PPI pretreatment and followed by prolonged PPI was highly successful in eradicating <i>H. pylori</i> infection and healing ulcers in pediatric patients with active peptic ulcer. This might be preferable as a first-line empiric treatment regimen for <i>H. pylori</i>-positive pediatric patients with peptic ulcers, especially in populations with high rates of resistance to amoxicillin and clarithromycin.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}