Helicobacter最新文献

{"title":"Ethnic Inequity in the Current Approach to H. pylori Testing and Treatment: Linked Data Cohort Analysis","authors":"Andrea Teng,&nbsp;Erin Hildred,&nbsp;James Stanley,&nbsp;Stephen Inns,&nbsp;Melissa McLeod","doi":"10.1111/hel.70005","DOIUrl":"10.1111/hel.70005","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>As seen globally, there are up to sixfold differences in gastric cancer mortality by ethnicity in Aotearoa New Zealand, and <i>H. pylori</i> is the major modifiable risk factor<i>.</i> This study investigates whether current <i>H. pylori</i> testing and treatment approaches are equitable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>The study design was a retrospective cohort analysis of linked administrative health data. Laboratory testing data and pharmacy dispensing were linked to the Northern region health user population dataset (1.9 million) from 2015 to 2018. We investigated an individual's first test for <i>H. pylori</i>. Regression analyses compared ethnic differences in rates of <i>H. pylori</i> testing, infection, treatment, and retesting, adjusted for age, sex, and calendar year.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ethnic inequities were present across the clinical pathway. Compared to sole-European, testing rates were lowest in Māori (OR 0.69) and Pacific (OR 0.81) and highest in Middle-Eastern/Latin-American/African (MELAA) (OR 2.21) and Asian (OR 2.02). Positivity rates were highest in MELAA (RR 2.96, 39%) and Pacific (RR 2.84, 38%) followed by Asian (RR 1.93, 26%) and Māori (RR 1.71, 23%). Treatment rates were similar for Asian (HR 1.05), MELAA (HR 1.03), and Māori (HR 0.98) compared to sole-European but lower in Pacific (HR 0.90). Māori and Pacific were half as likely to be retested as sole-European.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Despite the higher prevalence of <i>H. pylori</i> and gastric cancer, Māori and Pacific are relatively underserved with lower rates of testing and treatment than sole-European. Improved guidelines and the consistent application of these along with an equity-focused test and treat program are likely to be particularly beneficial for Māori and Pacific in addressing inequities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948082","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":"Combatting Helicobacter pylori: A Focus on Nanomaterials","authors":"Xuanping Wang,&nbsp;Xihui Felicia Chan,&nbsp;Yuyo Go,&nbsp;Yishen Wang,&nbsp;Tingyu Li,&nbsp;Gangshi Wang","doi":"10.1111/hel.70004","DOIUrl":"10.1111/hel.70004","url":null,"abstract":"<div>\u0000 \u0000 <p>Developing effective non-antibiotic antimicrobial strategies is essential for combating global antibiotic resistance, including resistance stemming from <i>Helicobacter pylori</i> (<i>H. pylori</i>) treatment. Nanomaterials offer a promising and innovative approach for non-antibiotic anti-<i>H. pylori</i> treatment strategies. This review highlights the progress made in the use of metallic and nonmetallic nanoparticles, as well as nanozymes, to directly inhibit <i>H. pylori</i> growth. Moreover, we summarize advances made in the direct targeting of <i>H. pylori</i> by nanomaterials and the stimuli-responsive release of nanoparticles in the stomach. Additionally, we explore the recent advancements in multifunctional nanoplatforms that integrate physical methods, such as light, heat, ultrasound, and magnetism, with nanomaterials to synergistically treat <i>H. pylori</i> infections. Finally, we briefly address the existing challenges and future directions in this field. In summary, we highlight that with ongoing research, nanomaterials may serve as a promising treatment strategy for <i>H. pylori</i> eradication.</p>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894198","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 Lactobacillus spp. Supplementation in Helicobacter pylori Eradication: A Systematic Meta-Analysis of Randomized Controlled Trials With Trial Sequential Analysis","authors":"Vivek Mishra,&nbsp;Debabrata Dash,&nbsp;Aditya K. Panda,&nbsp;Sushil Kumar Pathak","doi":"10.1111/hel.70006","DOIUrl":"10.1111/hel.70006","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;&lt;i&gt;Helicobacter pylori&lt;/i&gt; infection is a major global health concern and has been associated with a number of gastrointestinal disorders. Probiotics, especially &lt;i&gt;Lactobacillus&lt;/i&gt; spp., have been suggested to have beneficial effect in managing &lt;i&gt;H. pylori&lt;/i&gt; infection. This meta-analysis of randomized control trials (RCTs) aimed to evaluate the effect of &lt;i&gt;Lactobacillus&lt;/i&gt; spp. supplementation on &lt;i&gt;H. pylori&lt;/i&gt; eradication rates and associated side effects when combined with standard therapy.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Materials and Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Relevant studies were retrieved from PubMed, Scopus, Google Scholar and the Cochrane Library. Comprehensive Meta-Analysis (CMA) Software 4.0 was used for all the statistical analyses. TSA 0.9.5.10 Beta software was used for the trial sequential analysis (TSA). GRADEpro GDT was used to assess the certainty of evidence.&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;An analysis of 26 selected studies showed that supplementing with &lt;i&gt;Lactobacillus&lt;/i&gt; spp. significantly increased the rates of &lt;i&gt;H. pylori&lt;/i&gt; eradication in per-protocol (PP) analysis (Overall risk ratio [RR] = 1.063, &lt;i&gt;p&lt;/i&gt; = 0.000, 95% CI of −0.21 to 2.11; adults: RR = 1.050, &lt;i&gt;p&lt;/i&gt; = 0.005, 95% CI = −0.55 to 2.03, children: RR = 1.223, &lt;i&gt;p&lt;/i&gt; = 0.001, 95% CI = −13.35 to 4.55). In comparison to quadruple therapy, &lt;i&gt;Lactobacillus&lt;/i&gt; spp. supplementation to triple therapy showed significant benefit (RR: 1.124; &lt;i&gt;p&lt;/i&gt; = 0.000, 95% CI of −0.48 to 2.61). &lt;i&gt;L. reuteri&lt;/i&gt; supplementation indicated better efficacy (RR: 1.049; &lt;i&gt;p&lt;/i&gt; = 0.055, 95% CI of −0.56 to 3.26) than &lt;i&gt;Lactobacillus&lt;/i&gt; GG (RR: 0.980; &lt;i&gt;p&lt;/i&gt; = 0.595, 95% CI of −0.69 to 1.21). The 28–30 day (RR: 1.103; &lt;i&gt;p&lt;/i&gt; = 0.003, 95% CI of −2.14 to 4.19) and 14-day supplementation periods (RR: 1.102; p = 0.003, 95% CI of −1.69 to 3.51) showed the most improvement. The analysis also revealed that &lt;i&gt;Lactobacillus&lt;/i&gt; spp. significantly reduced gastrointestinal side effects: nausea/vomiting (RR: 0.566; &lt;i&gt;p&lt;/i&gt; = 0.037, −3.11 to 1.45), diarrhea (RR: 0.324; &lt;i&gt;p&lt;/i&gt; = 0.000, −5.46 to 0.48), and abdominal pain (RR: 0.438; &lt;i&gt;p&lt;/i&gt; = 0.007, −5.65 to 4.22). The effect on bloating was non-significant (RR: 0.820; &lt;i&gt;p&lt;/i&gt; = 0.498, −4.01 to 0.96). TSA graphs validated sufficient evidence for the conclusions.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;&lt;i&gt;Lactobacillus&lt;/i&gt; spp. significantly enhances &lt;i&gt;H. pylori&lt;/i&gt; eradication rates and may reduce gastrointestinal side effects when used alongside standard therapy, offering a promising adjunctive treatment option. The evidence was supported by TSA and asse","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894200","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":"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}