Publicação
Effectiveness of First-Line Empirical Treatment in Portugal: Data from the European Registry on Helicobacter pylori Management
| Resumo: | Abstract Introduction: As Portugal exhibits some of the highest gastric cancer rates in Europe, optimizing the Helicobacter pylori eradication rate is imperative. We aimed to describe H. pylori treatment regimens in Portugal, within a real clinical practice setting. Methods: This is a prospective cohort study of the Portuguese patients diagnosed with H. pylori between May 2013 and December 2022, within the European Registry on Helicobacter pylori Management (Hp-EuReg). The demographic and clinical data, diagnostic methods, treatment regimens, and prescription trends with their effectiveness were analysed by modified intention-to-treat (mITT) and per-protocol (PP) analyses. Results: Overall, 700 cases, mainly from 2 centres (98% of cases), were included, with 59% females, with a mean age of 54 ± 15 years. Treatment-naïve patients encompassed 81% of cases. Overall compliance (>90% drug intake) was reported in 99% of cases. Overall effectiveness was 87%, by both mITT and PP analyses. The triple PPI-clarithromycin-amoxicillin therapy decreased from 29% in 2013 to 0% in 2022. Conversely, both quadruple concomitant PPI-clarithromycin-amoxicillin-metronidazole and PPI-bismuth-metronidazole-tetracycline therapies were predominantly used from 2016 onwards, with PPI-bismuth-metronidazole-tetracycline representing 76% of all prescriptions in 2022, achieving an overall mITT effectiveness of 92% and 91%, respectively. Conclusion: In Portugal, concomitant quadruple therapy with PPI-clarithromycin-amoxicillin-metronidazole and bismuth quadruple with PPI-bismuth-metronidazole-tetracycline provided both optimal (>90%) effectiveness, in line with results of other Southern European countries. |
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| Autores principais: | Viegas,Maria Inês |
| Outros Autores: | Areia,Miguel; Elvas,Luís; Marcos-Pinto,Ricardo; Fernandes-Mendes,Henrique; Alves,Susana; Brito,Daniel; Saraiva,Sandra; Cadime,Ana Teresa; Cano-Català,Anna; Parra,Pablo; Moreira,Leticia; Mégraud,Francis; O’Morain,Colm; Nyssen,Olga P.; Gisbert,Javier P. |
| Assunto: | Helicobacter pylori Endoscopy Eradication Empirical treatment |
| Ano: | 2025 |
| País: | Portugal |
| Tipo de documento: | artigo |
| Tipo de acesso: | acesso aberto |
| Instituição associada: | Fundação para a Ciência e Tecnologia |
| Idioma: | inglês |
| Origem: | SciELO Portugal |
| Resumo: | Abstract Introduction: As Portugal exhibits some of the highest gastric cancer rates in Europe, optimizing the Helicobacter pylori eradication rate is imperative. We aimed to describe H. pylori treatment regimens in Portugal, within a real clinical practice setting. Methods: This is a prospective cohort study of the Portuguese patients diagnosed with H. pylori between May 2013 and December 2022, within the European Registry on Helicobacter pylori Management (Hp-EuReg). The demographic and clinical data, diagnostic methods, treatment regimens, and prescription trends with their effectiveness were analysed by modified intention-to-treat (mITT) and per-protocol (PP) analyses. Results: Overall, 700 cases, mainly from 2 centres (98% of cases), were included, with 59% females, with a mean age of 54 ± 15 years. Treatment-naïve patients encompassed 81% of cases. Overall compliance (>90% drug intake) was reported in 99% of cases. Overall effectiveness was 87%, by both mITT and PP analyses. The triple PPI-clarithromycin-amoxicillin therapy decreased from 29% in 2013 to 0% in 2022. Conversely, both quadruple concomitant PPI-clarithromycin-amoxicillin-metronidazole and PPI-bismuth-metronidazole-tetracycline therapies were predominantly used from 2016 onwards, with PPI-bismuth-metronidazole-tetracycline representing 76% of all prescriptions in 2022, achieving an overall mITT effectiveness of 92% and 91%, respectively. Conclusion: In Portugal, concomitant quadruple therapy with PPI-clarithromycin-amoxicillin-metronidazole and bismuth quadruple with PPI-bismuth-metronidazole-tetracycline provided both optimal (>90%) effectiveness, in line with results of other Southern European countries. |
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