Helicobacter最新文献

{"title":"Efficacy and Safety of Vonoprazan-Based Dual, Triple, and Quadruple Therapies for Helicobacter pylori Eradication: A Randomized Controlled Trial","authors":"Jin-Yan Zhang,&nbsp;Ji Li,&nbsp;Wei-Feng Huang,&nbsp;Xiao-Yi Lei,&nbsp;Yu-Lin Huang,&nbsp;Gui-Hua Xu,&nbsp;Dong Xu","doi":"10.1111/hel.70112","DOIUrl":"10.1111/hel.70112","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Vonoprazan (VPZ), a potassium-competitive acid blocker, has shown promising efficacy in <i>Helicobacter pylori</i> (<i>H. pylori</i>) eradication. However, direct comparisons of VPZ-based dual therapy (V-DT), triple therapy (V-TT), and bismuth quadruple therapy (V-BQT) remain limited. This study aimed to evaluate and compare the efficacy, safety, and compliance of these three regimens as first-line treatments for <i>H. pylori</i> infection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>375 adults were randomized (1:1:1) to receive V-DT (VPZ 20 mg bid + amoxicillin 1 g tid for 10 days), V-TT (VPZ 20 mg bid + amoxicillin 1 g bid + clarithromycin 500 mg bid for 14 days), or V-BQT (VPZ 20 mg bid + amoxicillin 1 g bid + clarithromycin 500 mg bid + bismuth 240 mg bid for 10 days). The primary outcome was <i>H. pylori</i> eradication rate by intention-to-treat (ITT), modified ITT (mITT), and per-protocol (PP) analyses. Secondary outcomes included adverse events and compliance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eradication rates were 92.0% (95% confidence interval [CI]: 85.8%–96.1%), 89.6% (95% CI: 82.9%–94.3%), and 88.8% (95% CI: 81.9%–93.7%) in ITT; 94.3% (95% CI: 88.5%–97.7%), 94.9% (95% CI: 89.3%–98.1%), and 94.1% (95% CI: 88.2%–97.6%) in mITT; and 94.2% (95% CI: 88.4%–97.6%), 95.6% (95% CI: 90.0%–98.5%), and 94.8% (95% CI: 89.0%–98.1%) in PP analyses for V-DT, V-TT, and V-BQT, respectively. The efficacy of V-DT and V-TT was noninferior to that of V-BQT. Adverse events were significantly lower with V-DT (6.4%) than with V-TT (36.0%) and V-BQT (49.6%) (<i>p</i> &lt; 0.001). Compliance exceeded 93% in all groups, with no significant differences (<i>p</i> = 0.250).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>All three regimens achieved high eradication rates, with V-DT and V-TT being statistically noninferior to V-BQT. The 10-day V-DT regimen achieved eradication rates comparable to V-BQT with substantially fewer adverse events and reduced antibiotic use, supporting its potential as a simplified first-line option for <i>H. pylori</i> eradication.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>Chinese Clinical Trial Registration Number: ChiCTR2300072857</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147354848","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":"Exosome-Based Detection of Helicobacter pylori Infection and Clarithromycin Resistance in Children","authors":"Minghui Song,&nbsp;Jingqing Zeng,&nbsp;Zhanyong Yao,&nbsp;Chundi Xu,&nbsp;Yiqiu Huang,&nbsp;Yuan Xiao,&nbsp;Yi Yu,&nbsp;Jia Li,&nbsp;Xu Xu,&nbsp;Chenchen Shi,&nbsp;Qiuchen Wu,&nbsp;Yonglin Tao,&nbsp;Xing Tang,&nbsp;Gloria Ge,&nbsp;Shenshen Gao,&nbsp;Zhaohui Deng,&nbsp;Xinqiong Wang","doi":"10.1111/hel.70113","DOIUrl":"10.1111/hel.70113","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The prevalence of <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection in children is high. Current diagnostic methods, particularly invasive techniques like gastroscopy, pose challenges for pediatric populations, highlighting the need for reliable non-invasive alternatives.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study aimed to evaluate the diagnostic value of salivary and urinary exosomes for detecting <i>H. pylori</i> infection and clarithromycin resistance in children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Saliva and urine samples were collected from children prior to elective gastroscopy. Exosomal DNA was extracted and subjected to qPCR for the detection of <i>H. pylori</i> DNA and clarithromycin resistance. The sensitivity and specificity of the salivary and urinary exosome tests were calculated against the reference standard, and their performance in detecting resistance was compared with tissue-based results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 500 enrolled children, the <i>H. pylori</i> infection rate was 31.6%. Analysis of 500 salivary and 80 urine samples showed that salivary exosomes detected <i>H. pylori</i> with a sensitivity of 93.67% and specificity of 80.11%. Urinary exosomes offered higher specificity (90.56%) but lower sensitivity (62.96%). In the subset of 113 infected children tested for resistance, salivary exosome testing identified clarithromycin resistance in 17.70% of cases, showing a 91.15% concordance with gastric tissue testing (15.93%). The agreement between the two methods was substantial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Salivary exosome-based detection represents a highly sensitive and well-tolerated non-invasive method for diagnosing <i>H. pylori</i> infection in children. It also demonstrates substantial agreement with invasive methods in identifying clarithromycin resistance, offering a promising tool to guide precise eradication therapy in the pediatric population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147354868","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":"Hope Hp-GC Project-Program Implementation for Primary and Secondary Prevention of Gastric Cancer in Latin America.","authors":"Javier Uribe, José Darío Portillo-Miño, Gonzalo Latorre, Diego Reyes-Placencia, Mauricio Pizarro, José Ignacio Vargas, Alberto Espino, Camila Jure, Margarita Pizarro, Gabriela Bofill, Felipe Silva, Nilton Palacios, Natalia Díaz-Garrido, Laura Huidobro, Raúl Araya, Sergio Ledesma, William Otero, Lina Otero, José M Remes-Troche, Christian Campos, Monserrate Largacha, Oscar Varas, Dacio Cabrera, Alejandro Piscoya, Juan Ramírez, Oscar Laudanno, Sebastián Esteves, Sandra Cifuentes, Eduardo García, Ana María-Guzmán, Douglas Morgan, Manuel Espinoza, Shailja C Shah, Jin Young Park, M Constanza Camargo, Arnoldo Riquelme","doi":"10.1111/hel.70109","DOIUrl":"https://doi.org/10.1111/hel.70109","url":null,"abstract":"<p><strong>Introduction: </strong>Gastric cancer (GC) is the fifth leading cause of cancer-related mortality globally; its main burden is concentrated in East Asia and some areas of Europe and Latin America. This study aims to develop an organized and structured GC prevention pilot program in intermediate-to-high-incidence countries in Latin America.</p><p><strong>Methods: </strong>This study involved two strategies: (a) primary prevention for screen-and-treat H. pylori infection among individuals aged 30-39 years (n = 7500, 500 in 15 sites), and (b) primary and secondary prevention for individuals aged 40-75 years (n = 9600, 600 in 16 sites) with tiered risk stratification using an algorithm developed and validated in Chile (Gastrocalc: priority 1 to 6; age, sex, hypertension, IgG H. pylori, pepsinogen I and II, and Gastrin-17b), and high-quality esophagogastroduodenoscopy (EGD) evaluation.</p><p><strong>Results: </strong>Pilot phases were successfully conducted in Chile and Colombia during 2023-2025. In Chile (Molina), 4152 asymptomatic individuals were tested with H. pylori prevalence of 46% (n = 113/246) in 2023, 34% (n = 504/1484) in 2024, and 32% (n = 609/1904) in 2025. The H. pylori prevalence among individuals aged 30-39 years (592/4152; 14.3%) was 37.8%. In Colombia, 1250 asymptomatic individuals were screened across four regions; in 2025, the prevalence of H. pylori among individuals aged 30-39 years was 69% (n = 895/1250). The validation of Gastrocalc included 866 individuals from 5 regions in Chile. The algorithm successfully identified 80.6% of OLGA III-IV patients and 100% of GC patients (Priority 1-4). Other countries will start activities in 2026.</p><p><strong>Conclusions: </strong>This pioneering study will advance understanding and feasibility of urgently needed primary and secondary prevention for GC in Latin America.</p>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 2","pages":"e70109"},"PeriodicalIF":4.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722864","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":"Individuals and Family-Screen-to-Treat-Based Helicobacter pylori Eradication Strategy for Gastric Cancer Prevention: A Latin American Perspective.","authors":"José Darío Portillo-Miño, Javier Uribe, Gonzalo Latorre, Mauricio Pizarro, Margarita Pizarro, Nilton Palacios, Natalia Díaz-Garrido, Camila Jure, Diego Reyes-Placencia, William Otero, Sandra Cifuentes, Oscar Laudanno, José M Remes-Troche, Alejandro Piscoya, Arnoldo Riquelme","doi":"10.1111/hel.70110","DOIUrl":"https://doi.org/10.1111/hel.70110","url":null,"abstract":"<p><p>Gastric cancer (GC) is a public health concern due to estimates indicating it ranks among the most prevalent cancers and leading causes of cancer-related deaths globally. In Latin America, a region significantly impacted by high mortality and incidence of GC, chronic H. pylori infection remains the primary cause of GC, with an overall prevalence of around 42.5% from 2015 to 2022. Asian countries have developed innovative strategies for primary and secondary prevention. Among the most notable primary and secondary screening programs were endoscopy-based screening in Japan and South Korea; a nationwide population-based H. pylori eradication program in Bhutan; mass H. pylori eradication in the Matsu Islands of Taiwan; and a recently developed family-based H. pylori eradication strategy in China. In this Opinion Review, we discuss the opportunities and pitfalls of implementing an individual-and family-screening-based H. pylori eradication strategy for GC prevention in Latin American intermediate- and high-risk areas.</p>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 2","pages":"e70110"},"PeriodicalIF":4.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728700","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":"Susceptibility-Guided Versus Empirical First-Line Therapy of Helicobacter pylori Infection in Adults: A Systematic Review and Meta-Analysis.","authors":"Manuel Coelho Rocha, Tiago Gaspar, Carlos Bernardes, Pedro Pimentel Nunes","doi":"10.1111/hel.70125","DOIUrl":"10.1111/hel.70125","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial resistance undermines empirical first-line regimens for Helicobacter pylori. We compared susceptibility-guided therapy (SGT) versus empirical therapy in adults receiving first-line treatment, focusing on intention-to-treat (ITT) eradication.</p><p><strong>Materials and methods: </strong>We searched MEDLINE (PubMed), Web of Science, and Scopus from inception to 30 September 2025 for randomized controlled trials (RCTs) and non-randomized comparative studies (NRS) in adults with confirmed H. pylori. Interventions included phenotypic (culture/E-test) or genotypic (PCR) SGT applied to biopsy, stool, or gastric juice specimens; comparators were empirical regimens including bismuth quadruple therapy (BQT) and non-BQT options. The primary outcome was ITT eradication. We pooled risk ratios (RR) with DerSimonian-Laird random-effects, reported I²/τ², and derived 95% prediction intervals (PI). Subgroups were prespecified by comparator family (BQT vs. other) and specimen/method. Multi-arm studies combined empirical arms within family or split across distinct families.</p><p><strong>Results: </strong>Forty-two studies met inclusion criteria; all contributed ITT data. RCTs (k = 33) favored SGT over empirical therapy (pooled RR 1.09, 95% CI 1.05-1.13; I² 73%; 95% PI 0.92-1.30). NRS (k = 12) were directionally consistent (pooled RR 1.15, 95% CI 1.10-1.22; I² 75%; 95% PI 0.99-1.35). In RCTs, effects were neutral-to-modest vs. BQT (RR 1.03, 95% CI 0.97-1.10) and clearer vs. other empirical regimens (RR 1.12, 95% CI 1.06-1.18).</p><p><strong>Conclusions: </strong>In adult first-line therapy, SGT achieves at least non-inferior-and often superior-eradication versus empirical regimens; the incremental benefit is attenuated where BQT is standard. These findings support selective, and increasingly justified, integration of susceptibility testing in settings with clinically relevant resistance.</p>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 2","pages":"e70125"},"PeriodicalIF":4.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13080058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147690023","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":"Overview of Gastric Cancer Prevention Initiatives in Europe.","authors":"Marcis Leja, Danute Ražuka-Ebela, Bojan Tepes, Jan Bornschein, Mário Dinis Ribeiro, Tamara Matysiak Budnik, Jochen Weigt, Viktoria Knaze, Colm O'Morain, Duco T Mülder, Iris Lansdorp-Vogelaar, Marianna Vitaloni, Tessa Groen, Marlon van Loo, Janet Takens, Javier P Gisbert, Jin Young Park","doi":"10.1111/hel.70126","DOIUrl":"https://doi.org/10.1111/hel.70126","url":null,"abstract":"<p><strong>Background: </strong>Gastric cancer continues to impose a substantial health burden in Europe. The European Council Recommendations have called for consideration of implementing measures aimed at reducing gastric cancer-related mortality.</p><p><strong>Methods: </strong>This manuscript reviews current gastric cancer prevention initiatives in Europe. The GISTAR study in Latvia has been enrolling participants from the general population for Helicobacter pylori screen-and-treat intervention together with serological testing for pepsinogens. The EUROHELICAN study was the first to evaluate an H. pylori screen-and-treat strategy in young adults, which has been expanded within the TOGAS project. In addition, TOGAS has addressed stakeholder perspectives, the cost-effectiveness of screen-and-treat strategies, and the prevalence of gastric precancerous conditions among individuals participating in colorectal cancer screening. The GISTAR cohort has also enabled the assessment of long-term outcomes following H. pylori eradication. The EUGastScreen project, carried out within the EUCanScreen Joint Action, aims to evaluate the feasibility of simultaneous screening for H. pylori infection and colorectal cancer using a stool-based test. The European Registry on H. pylori Management (Hp-EuReg) supports the collection of important clinical data from routine clinical practice. Furthermore, the development of European guidelines for gastric cancer prevention has been initiated as part of the European Commission Initiative on Gastric Cancer and is expected to continue until 2027. The recently published 5th edition of the European Code Against Cancer includes recommendations on H. pylori management for the first time.</p><p><strong>Conclusions: </strong>Ongoing initiatives will provide important evidence to support the future implementation of gastric cancer prevention strategies, including data on feasibility, acceptability among the general population and stakeholders, and cost-effectiveness. However, additional implementation studies for gastric cancer prevention will be required.</p>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 2","pages":"e70126"},"PeriodicalIF":4.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147690014","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":"Emerging Primary Amoxicillin Resistance in Helicobacter pylori in Vietnam: Evidence of Erosion of a Long-Standing Beta-Lactam Backbone.","authors":"Duc Trong Quach, Anh Tuan Nguyen, Nhu Thi Hanh Vu, Doan Thi Nha Nguyen","doi":"10.1111/hel.70129","DOIUrl":"https://doi.org/10.1111/hel.70129","url":null,"abstract":"","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 2","pages":"e70129"},"PeriodicalIF":4.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770132","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":"Exploration of a Potential Amoxicillin MIC Threshold in Bismuth Quadruple Therapy for H. pylori Infection in Southeastern China.","authors":"Ding Lu, Zhen-Wei Yang, Yun-Fan Dong, Yu-Wei Zhang, Jiang Liu","doi":"10.1111/hel.70117","DOIUrl":"https://doi.org/10.1111/hel.70117","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The European Committee on Antimicrobial Susceptibility Testing (EUCAST) defines the amoxicillin resistance breakpoint at a minimum inhibitory concentration (MIC) of 0.125 μg/mL. This breakpoint is widely applied, and its clinical relevance has been validated in regions where amoxicillin-based triple therapy is the standard. However, in the context of China's predominant use of quadruple therapy, the applicability of this breakpoint remains unclear. This study aimed to collect Southeastern China resistance data, assess the impact of different amoxicillin MIC thresholds on the efficacy of amoxicillin-containing quadruple therapy, and to explore candidate amoxicillin MIC thresholds potentially associated with treatment outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Gastric mucosal specimens were obtained from patients undergoing gastroscopy between March 2024 and March 2025. A total of 4203 Helicobacter pylori isolates were successfully cultured and included for in vitro susceptibility testing. In vitro susceptibility testing of H. pylori isolates was performed using the agar dilution method, with MIC thresholds for amoxicillin set at 0.125 μg/mL, 0.25 μg/mL, 0.5 μg/mL, 1 μg/mL, and 2 μg/mL and other antibiotics (clarithromycin, metronidazole, levofloxacin) was performed on H. pylori isolates via agar dilution method. Patients treated with an amoxicillin-containing quadruple regimen (rabeprazole 10 mg twice daily + bismuth potassium citrate 220 mg twice daily + amoxicillin 1.0 g twice daily + furazolidone 100 mg twice daily or tetracycline 100 mg twice daily) were followed up. Eradication status was assessed by &lt;sup&gt;13&lt;/sup&gt;C-urea breath test 6-8 weeks post-treatment. Eradication rates were calculated using both intention-to-treat (ITT) and per-protocol (PP) analyses. χ&lt;sup&gt;2&lt;/sup&gt; test with Yates' continuity correlation and Fisher's exact tests were applied for group comparisons. Kappa statistics were used to evaluate the level of agreement between resistance classification under different MIC thresholds and clinical eradication outcomes. Prespecified stratified analyses were performed, and interaction terms were included in regression models to examine whether the association between amoxicillin MIC and eradication outcomes was consistent across treatment regimens and clinical subgroups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 342 patients were included in the ITT analysis, and 330 patients were included in the PP analysis after excluding 14 patients due to adverse events or loss to follow-up. When the MIC breakpoint was set at 0.125 μg/mL or 0.25 μg/mL, no statistically significant difference was observed between resistant and susceptible groups in eradication rates (0.125 μg/mL: resistant ITT 88.57%, PP 90.29% vs. susceptible ITT 91.56%, PP 95.59%; 0.25 μg/mL: resistant ITT 86.89%, PP 88.33% vs. susceptible ITT 91.46%, PP 95.19%; all p &gt; 0.05). At 0.5 μg/mL, eradication rates in resistant patients were significantly ","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 2","pages":"e70117"},"PeriodicalIF":4.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770123","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":"Long-Term Effect of Macrolides on Helicobacter pylori Eradication: Data From the European Registry on Helicobacter pylori Management (Hp-EuReg)","authors":"Olga P. Nyssen,&nbsp;Guillermo J. Ortega,&nbsp;Laimas Jonaitis,&nbsp;Ángeles Pérez-Aísa,&nbsp;Bojan Tepes,&nbsp;Alfredo J. Lucendo,&nbsp;Javier Tejedor-Tejada,&nbsp;Renate Bumane,&nbsp;Ana Garre,&nbsp;Jose M. Huguet,&nbsp;Monica Perona,&nbsp;Óscar Núñez,&nbsp;Manuel Pabón-Carrasco,&nbsp;Manuel Castro-Fernández,&nbsp;Miguel Areia,&nbsp;Jesús Barrio,&nbsp;Antonio Moreno Loro,&nbsp;Thomas J. Butler,&nbsp;María Soledad Marcos,&nbsp;Alma Keco-Huerga,&nbsp;Manuel Domínguez Cajal,&nbsp;Maja Denkovski,&nbsp;Matteo Pavoni,&nbsp;György Miklós Buzás,&nbsp;Frode Lerang,&nbsp;Giuseppe Losurdo,&nbsp;Pablo M. Wolfe García,&nbsp;Perminder S. Phull,&nbsp;Samuel J. Martínez-Domínguez,&nbsp;Juozas Kupcinskas,&nbsp;Mārcis Leja,&nbsp;Ricardo Marcos-Pinto,&nbsp;Sinead M. Smith,&nbsp;Antonio Gasbarrini,&nbsp;Veronika Papp,&nbsp;Blas José Gómez Rodríguez,&nbsp;Mónica Sánchez Alonso,&nbsp;Ramón Pajares Villarroya,&nbsp;Pilar Pazo Mejide,&nbsp;Manuel Jiménez-Moreno,&nbsp;Marta Pascual-Mato,&nbsp;Concepción Bravo-Pache,&nbsp;Milagrosa Montes,&nbsp;Anna Cano-Català,&nbsp;Pablo Parra,&nbsp;Leticia Moreira,&nbsp;Francis Mégraud,&nbsp;Colm O’Morain,&nbsp;Luis Bujanda,&nbsp;Javier P. Gisbert,&nbsp;the Hp-EuReg investigators","doi":"10.1111/hel.70107","DOIUrl":"10.1111/hel.70107","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Previous antibiotic use influences <i>Helicobacter pylori</i> antibiotic resistance. This study evaluated how prior population-level macrolide (especially clarithromycin) use affects <i>H. pylori</i> eradication success in naïve patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective, multicenter, ecological study. Multivariate logistic regression was performed with modified intention-to-treat effectiveness as the main outcome. Key variables included first-line clarithromycin-based treatments, therapy duration (7, 10, 14 days), proton pump inhibitor dose (low, standard, high), compliance (&gt; 90%), and clarithromycin consumption (defined daily doses/1000 inhabitants/day, from the European Surveillance of Antimicrobial Consumption Network). Nested hierarchical models incorporated macrolide consumption, matched by year and country, and assessed the interaction between consumption and first-line empirical treatments from the European Registry on <i>H. pylori</i> Management (Hp-EuReg).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 27,549 naïve patients from 23 countries with macrolide consumption data from 2013 to 2022. Higher macrolide consumption, within 0 to 8 years before treatment, was associated with reduced treatment effectiveness. The eradication rate consistently decreased as macrolide consumption increased, particularly within the previous 4 years. The efficacy of triple-clarithromycin-metronidazole, triple-clarithromycin-amoxicillin, and some bismuth-quadruple therapies containing clarithromycin decreased with higher macrolide consumption. At the country level, higher population consumption of clarithromycin 2 years before treatment was associated with a decrease in eradication rates from 93% to 82%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Higher macrolide consumption in the general population negatively impacts the effectiveness of first-line <i>H. pylori</i> regimens. These findings support that clarithromycin should only be administered as a susceptibility-based therapy, with the strongest negative impact of prior population-level exposure observed within 5 years and diminishing thereafter. ClincialTrials.gov number, NCT02328131.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12884029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146142308","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":"Efficacy and Safety of Keverprazan–Amoxicillin Dual Regimen in Initial Eradication of Helicobacter pylori Infection: A Multicenter, Randomized Controlled Trial","authors":"Shanshan Wei,&nbsp;Zhihao Huang,&nbsp;Huizhen Xiong,&nbsp;Ji Wu,&nbsp;Dihua Mei,&nbsp;Jing Zhao,&nbsp;Wei Liu,&nbsp;Qingyun Liu,&nbsp;Yu Lin,&nbsp;Fang Liu,&nbsp;Xiang Peng,&nbsp;Honglei Chen","doi":"10.1111/hel.70100","DOIUrl":"10.1111/hel.70100","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The efficacy of keverprazan–amoxicillin dual therapy (KA) in the treatment of <i>Helicobacter pylori</i> (<i>H. pylori</i>) has not yet been demonstrated. Here, we aimed to compare the eradication rate of the KA regimen with esomeprazole-based bismuth quadruple therapy (EBQT) containing amoxicillin and clarithromycin for <i>H. pylori</i> initial eradication in the Chinese population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients aged between 18–75 years were randomly assigned into KA group or the EBQT group. The KA group patients received keverprazan 20 mg (b.i.d.) and amoxicillin 1.0 g (t.i.d.) for 14 days. The EBQT group patients took esomeprazole 20 mg (b.i.d.), amoxicillin 1.0 g (b.i.d.), clarithromycin 0.5 g (b.i.d.), and bismuth potassium citrate 220 mg (b.i.d.) for 14 days. The primary outcome was the <i>H. pylori</i> eradication rate 28 days after therapy. Secondary outcomes included compliance and adverse events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 394 patients were enrolled in this study. Eradication rates in the KA group and the EBQT group were 87.88% and 84.18% in intention-to-treat analysis (ITT) (rate difference: 3.70%, 95% CI: −3.14% to 10.53%), 92.55% and 88.24% in modified ITT analysis (rate difference: 4.32%, 95% CI: −1.63% to 10.27%), and 93.99% and 90.56% in per-protocol analysis (PP) (rate difference: 3.43%, 95% CI: −2.05% to 8.92%), respectively. The eradication rates for the KA group were not inferior to those of the EBQT group in ITT, modified ITT, and PP analysis. The incidences of nausea and overall adverse effects in the KA group were significantly lower than those of the EBQT group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Keverprazan 20 mg twice daily with high-dose amoxicillin demonstrates a noninferior efficacy to bismuth quadruple therapy for initial <i>H. pylori</i> eradication.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>Chinese Clinical Trial Registry, registration No: ChiCTR2400092511</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146124822","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}