Role of compliance in Helicobacter pylori eradication treatment: Results of the European Registry on H. pylori management

Jose M. Huguet; Luis Ferrer-Barceló; Patrícia Suárez; Susana Barcelo-Cerda; Javier Sempere; Ilaria Maria Saracino; Giulia Fiorini; Dino Vaira; Ángeles Pérez-Aísa; Laimas Jonaitis; Bojan Tepes; M. Castro-Fernandez; Manuel Pabón-Carrasco; Alma Keco-Huerga; Irina Voynovan; Alfredo J. Lucendo; Ángel Lanas; Samuel J. Martínez-Domínguez; Enrique Alfaro Almajano; Luis Rodrigo; Ludmila Vologzanina; Dmitry S. Bordin; Antonio Gasbarrini; Gülüstan Babayeva; Frode Lerang; Mārcis Leja; Juozas Kupčinskas; Theodore Rokkas; Ricardo Marcos-Pinto; Antonio Meštrović; Oleksiy Gridnyev; Perminder S. Phull; Sinead M. Smith; Doron Boltin; György Miklós Buzás; Jan Kral; Halis Şimşek; Tamara Matysiak-Budnik; Vladimir Milivojevic; Wojciech Marlicz; Marino Venerito; Lyudmila Boyanova; Michael Doulberis; Lisette G. Capelle; Anna Cano-Català; Leticia Moreira; Olga P. Nyssen; Francis Mégraud; Colm O’Morain; Javier P. Gisbert

doi:10.1002/ueg2.12569

Role of compliance in Helicobacter pylori eradication treatment: Results of the European Registry on H. pylori management

Jose M. Huguet
, Luis Ferrer-Barceló
, Patrícia Suárez
, Susana Barcelo-Cerda
, Javier Sempere
, Ilaria Maria Saracino
, Giulia Fiorini
, Dino Vaira
, Ángeles Pérez-Aísa
, Laimas Jonaitis
, Bojan Tepes
, M. Castro-Fernandez
, Manuel Pabón-Carrasco
, Alma Keco-Huerga
, Irina Voynovan
, Alfredo J. Lucendo
, Ángel Lanas
, Samuel J. Martínez-Domínguez
, Enrique Alfaro Almajano
, Luis Rodrigo

Ludmila Vologzanina, Dmitry S. Bordin, Antonio Gasbarrini, Gülüstan Babayeva, Frode Lerang, Mārcis Leja, Juozas Kupčinskas, Theodore Rokkas, Ricardo Marcos-Pinto, Antonio Meštrović, Oleksiy Gridnyev, Perminder S. Phull, Sinead M. Smith, Doron Boltin, György Miklós Buzás, Jan Kral, Halis Şimşek, Tamara Matysiak-Budnik, Vladimir Milivojevic, Wojciech Marlicz, Marino Venerito, Lyudmila Boyanova, Michael Doulberis, Lisette G. Capelle, Anna Cano-Català, Leticia Moreira, Olga P. Nyssen, Francis Mégraud, Colm O’Morain, Javier P. Gisbert

Polytechnic University of Valencia
University of Bologna
Hospital Clinico Universitario Lozano Blesa
University of Oviedo
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
University of Porto
NHS Grampian
Tel Aviv University
Charles University
Hacettepe University
University of Belgrade
Pomeranian Medical University in Szczecin
Otto von Guericke University Magdeburg
Meander Medical Center
University of Barcelona

Research output: Contribution to journal › Article › peer-review

37 Citations (Scopus)

Abstract

Background: Adherence to Helicobacter pylori (H. pylori) eradication treatment is a cornerstone for achieving adequate treatment efficacy. Objective: To determine which factors influence compliance with treatment. Methods: A systematic prospective non-interventional registry (Hp-EuReg) of the clinical practice of European gastroenterologists. Compliance was considered adequate if ≥90% drug intake. Data were collected until September 2021 using the AEG-REDCap e-CRF and were subjected to quality control. Modified intention-to-treat analyses were performed. Multivariate analysis carried out the factors associated with the effectiveness of treatment and compliance. Results: Compliance was inadequate in 646 (1.7%) of 38,698 patients. The non-compliance rate was higher in patients prescribed longer regimens (10-, 14-days) and rescue treatments, patients with uninvestigated dyspepsia/functional dyspepsia, and patients reporting adverse effects. Prevalence of non-adherence was lower for first-line treatment than for rescue treatment (1.5% vs. 2.2%; p < 0.001). Differences in non-adherence in the three most frequent first-line treatments were shown: 1.1% with proton pump inhibitor + clarithromycin + amoxicillin; 2.3% with proton pump inhibitor clarithromycin amoxicillin metronidazole; and 1.8% with bismuth quadruple therapy. These treatments were significantly more effective in compliant than in non-compliant patients: 86% versus 44%, 90% versus 71%, and 93% versus 64%, respectively (p < 0.001). In the multivariate analysis, the variable most significantly associated with higher effectiveness was adequate compliance (odds ratio, 6.3 [95%CI, 5.2–7.7]; p < 0.001). Conclusions: Compliance with Helicobacter pylori eradication treatment is very good. Factors associated with poor compliance include uninvestigated/functional dyspepsia, rescue-treatment, prolonged treatment regimens, the presence of adverse events, and the use of non-bismuth sequential and concomitant treatment. Adequate treatment compliance was the variable most closely associated with successful eradication.

Original language	English
Pages (from-to)	691-704
Journal	United European Gastroenterology Journal
Volume	12
Issue number	6
DOIs	https://doi.org/10.1002/ueg2.12569
Publication status	Published - Jul 2024

OECD Field of Science

3. Medical and Health Sciences

Keywords

adherence
adverse effects
bismuth
dyspepsia
effectiveness
efficacy
first line
rate
regimens
rescue

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10.1002/ueg2.12569

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Huguet, J. M., Ferrer-Barceló, L., Suárez, P., Barcelo-Cerda, S., Sempere, J., Saracino, I. M., Fiorini, G., Vaira, D., Pérez-Aísa, Á., Jonaitis, L., Tepes, B., Castro-Fernandez, M., Pabón-Carrasco, M., Keco-Huerga, A., Voynovan, I., Lucendo, A. J., Lanas, Á., Martínez-Domínguez, S. J., Alfaro Almajano, E., ... Gisbert, J. P. (2024). Role of compliance in Helicobacter pylori eradication treatment: Results of the European Registry on H. pylori management. United European Gastroenterology Journal, 12(6), 691-704. https://doi.org/10.1002/ueg2.12569

@article{b35214eef0c94623a75366954805ef0b,

title = "Role of compliance in Helicobacter pylori eradication treatment: Results of the European Registry on H. pylori management",

abstract = "Background: Adherence to Helicobacter pylori (H. pylori) eradication treatment is a cornerstone for achieving adequate treatment efficacy. Objective: To determine which factors influence compliance with treatment. Methods: A systematic prospective non-interventional registry (Hp-EuReg) of the clinical practice of European gastroenterologists. Compliance was considered adequate if ≥90\% drug intake. Data were collected until September 2021 using the AEG-REDCap e-CRF and were subjected to quality control. Modified intention-to-treat analyses were performed. Multivariate analysis carried out the factors associated with the effectiveness of treatment and compliance. Results: Compliance was inadequate in 646 (1.7\%) of 38,698 patients. The non-compliance rate was higher in patients prescribed longer regimens (10-, 14-days) and rescue treatments, patients with uninvestigated dyspepsia/functional dyspepsia, and patients reporting adverse effects. Prevalence of non-adherence was lower for first-line treatment than for rescue treatment (1.5\% vs. 2.2\%; p < 0.001). Differences in non-adherence in the three most frequent first-line treatments were shown: 1.1\% with proton pump inhibitor + clarithromycin + amoxicillin; 2.3\% with proton pump inhibitor clarithromycin amoxicillin metronidazole; and 1.8\% with bismuth quadruple therapy. These treatments were significantly more effective in compliant than in non-compliant patients: 86\% versus 44\%, 90\% versus 71\%, and 93\% versus 64\%, respectively (p < 0.001). In the multivariate analysis, the variable most significantly associated with higher effectiveness was adequate compliance (odds ratio, 6.3 [95\%CI, 5.2–7.7]; p < 0.001). Conclusions: Compliance with Helicobacter pylori eradication treatment is very good. Factors associated with poor compliance include uninvestigated/functional dyspepsia, rescue-treatment, prolonged treatment regimens, the presence of adverse events, and the use of non-bismuth sequential and concomitant treatment. Adequate treatment compliance was the variable most closely associated with successful eradication.",

keywords = "adherence, adverse effects, bismuth, dyspepsia, effectiveness, efficacy, first line, rate, regimens, rescue",

author = "Huguet, \{Jose M.\} and Luis Ferrer-Barcel{\'o} and Patr{\'i}cia Su{\'a}rez and Susana Barcelo-Cerda and Javier Sempere and Saracino, \{Ilaria Maria\} and Giulia Fiorini and Dino Vaira and {\'A}ngeles P{\'e}rez-A{\'i}sa and Laimas Jonaitis and Bojan Tepes and M. Castro-Fernandez and Manuel Pab{\'o}n-Carrasco and Alma Keco-Huerga and Irina Voynovan and Lucendo, \{Alfredo J.\} and {\'A}ngel Lanas and Mart{\'i}nez-Dom{\'i}nguez, \{Samuel J.\} and \{Alfaro Almajano\}, Enrique and Luis Rodrigo and Ludmila Vologzanina and Bordin, \{Dmitry S.\} and Antonio Gasbarrini and G{\"u}l{\"u}stan Babayeva and Frode Lerang and Mārcis Leja and Juozas Kup{\v c}inskas and Theodore Rokkas and Ricardo Marcos-Pinto and Antonio Me{\v s}trovi{\'c} and Oleksiy Gridnyev and Phull, \{Perminder S.\} and Smith, \{Sinead M.\} and Doron Boltin and Buz{\'a}s, \{Gy{\"o}rgy Mikl{\'o}s\} and Jan Kral and Halis {\c S}im{\c s}ek and Tamara Matysiak-Budnik and Vladimir Milivojevic and Wojciech Marlicz and Marino Venerito and Lyudmila Boyanova and Michael Doulberis and Capelle, \{Lisette G.\} and Anna Cano-Catal{\`a} and Leticia Moreira and Nyssen, \{Olga P.\} and Francis M{\'e}graud and Colm O{\textquoteright}Morain and Gisbert, \{Javier P.\}",

note = "Publisher Copyright: {\textcopyright} 2024 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology.",

year = "2024",

month = jul,

doi = "10.1002/ueg2.12569",

language = "English",

volume = "12",

pages = "691--704",

journal = "United European Gastroenterology Journal",

issn = "2050-6406",

publisher = "John Wiley \& Sons Inc.",

number = "6",

}

Huguet, JM, Ferrer-Barceló, L, Suárez, P, Barcelo-Cerda, S, Sempere, J, Saracino, IM, Fiorini, G, Vaira, D, Pérez-Aísa, Á, Jonaitis, L, Tepes, B, Castro-Fernandez, M, Pabón-Carrasco, M, Keco-Huerga, A, Voynovan, I, Lucendo, AJ, Lanas, Á, Martínez-Domínguez, SJ, Alfaro Almajano, E, Rodrigo, L, Vologzanina, L, Bordin, DS, Gasbarrini, A, Babayeva, G, Lerang, F, Leja, M, Kupčinskas, J, Rokkas, T, Marcos-Pinto, R, Meštrović, A, Gridnyev, O, Phull, PS, Smith, SM, Boltin, D, Buzás, GM, Kral, J, Şimşek, H, Matysiak-Budnik, T, Milivojevic, V, Marlicz, W, Venerito, M, Boyanova, L, Doulberis, M, Capelle, LG, Cano-Català, A, Moreira, L, Nyssen, OP, Mégraud, F, O’Morain, C & Gisbert, JP 2024, 'Role of compliance in Helicobacter pylori eradication treatment: Results of the European Registry on H. pylori management', United European Gastroenterology Journal, vol. 12, no. 6, pp. 691-704. https://doi.org/10.1002/ueg2.12569

TY - JOUR

T1 - Role of compliance in Helicobacter pylori eradication treatment: Results of the European Registry on H. pylori management

AU - Huguet, Jose M.

AU - Ferrer-Barceló, Luis

AU - Suárez, Patrícia

AU - Barcelo-Cerda, Susana

AU - Sempere, Javier

AU - Saracino, Ilaria Maria

AU - Fiorini, Giulia

AU - Vaira, Dino

AU - Pérez-Aísa, Ángeles

AU - Jonaitis, Laimas

AU - Tepes, Bojan

AU - Castro-Fernandez, M.

AU - Pabón-Carrasco, Manuel

AU - Keco-Huerga, Alma

AU - Voynovan, Irina

AU - Lucendo, Alfredo J.

AU - Lanas, Ángel

AU - Martínez-Domínguez, Samuel J.

AU - Alfaro Almajano, Enrique

AU - Rodrigo, Luis

AU - Vologzanina, Ludmila

AU - Bordin, Dmitry S.

AU - Gasbarrini, Antonio

AU - Babayeva, Gülüstan

AU - Lerang, Frode

AU - Leja, Mārcis

AU - Kupčinskas, Juozas

AU - Rokkas, Theodore

AU - Marcos-Pinto, Ricardo

AU - Meštrović, Antonio

AU - Gridnyev, Oleksiy

AU - Phull, Perminder S.

AU - Smith, Sinead M.

AU - Boltin, Doron

AU - Buzás, György Miklós

AU - Kral, Jan

AU - Şimşek, Halis

AU - Matysiak-Budnik, Tamara

AU - Milivojevic, Vladimir

AU - Marlicz, Wojciech

AU - Venerito, Marino

AU - Boyanova, Lyudmila

AU - Doulberis, Michael

AU - Capelle, Lisette G.

AU - Cano-Català, Anna

AU - Moreira, Leticia

AU - Nyssen, Olga P.

AU - Mégraud, Francis

AU - O’Morain, Colm

AU - Gisbert, Javier P.

PY - 2024/7

Y1 - 2024/7

N2 - Background: Adherence to Helicobacter pylori (H. pylori) eradication treatment is a cornerstone for achieving adequate treatment efficacy. Objective: To determine which factors influence compliance with treatment. Methods: A systematic prospective non-interventional registry (Hp-EuReg) of the clinical practice of European gastroenterologists. Compliance was considered adequate if ≥90% drug intake. Data were collected until September 2021 using the AEG-REDCap e-CRF and were subjected to quality control. Modified intention-to-treat analyses were performed. Multivariate analysis carried out the factors associated with the effectiveness of treatment and compliance. Results: Compliance was inadequate in 646 (1.7%) of 38,698 patients. The non-compliance rate was higher in patients prescribed longer regimens (10-, 14-days) and rescue treatments, patients with uninvestigated dyspepsia/functional dyspepsia, and patients reporting adverse effects. Prevalence of non-adherence was lower for first-line treatment than for rescue treatment (1.5% vs. 2.2%; p < 0.001). Differences in non-adherence in the three most frequent first-line treatments were shown: 1.1% with proton pump inhibitor + clarithromycin + amoxicillin; 2.3% with proton pump inhibitor clarithromycin amoxicillin metronidazole; and 1.8% with bismuth quadruple therapy. These treatments were significantly more effective in compliant than in non-compliant patients: 86% versus 44%, 90% versus 71%, and 93% versus 64%, respectively (p < 0.001). In the multivariate analysis, the variable most significantly associated with higher effectiveness was adequate compliance (odds ratio, 6.3 [95%CI, 5.2–7.7]; p < 0.001). Conclusions: Compliance with Helicobacter pylori eradication treatment is very good. Factors associated with poor compliance include uninvestigated/functional dyspepsia, rescue-treatment, prolonged treatment regimens, the presence of adverse events, and the use of non-bismuth sequential and concomitant treatment. Adequate treatment compliance was the variable most closely associated with successful eradication.

AB - Background: Adherence to Helicobacter pylori (H. pylori) eradication treatment is a cornerstone for achieving adequate treatment efficacy. Objective: To determine which factors influence compliance with treatment. Methods: A systematic prospective non-interventional registry (Hp-EuReg) of the clinical practice of European gastroenterologists. Compliance was considered adequate if ≥90% drug intake. Data were collected until September 2021 using the AEG-REDCap e-CRF and were subjected to quality control. Modified intention-to-treat analyses were performed. Multivariate analysis carried out the factors associated with the effectiveness of treatment and compliance. Results: Compliance was inadequate in 646 (1.7%) of 38,698 patients. The non-compliance rate was higher in patients prescribed longer regimens (10-, 14-days) and rescue treatments, patients with uninvestigated dyspepsia/functional dyspepsia, and patients reporting adverse effects. Prevalence of non-adherence was lower for first-line treatment than for rescue treatment (1.5% vs. 2.2%; p < 0.001). Differences in non-adherence in the three most frequent first-line treatments were shown: 1.1% with proton pump inhibitor + clarithromycin + amoxicillin; 2.3% with proton pump inhibitor clarithromycin amoxicillin metronidazole; and 1.8% with bismuth quadruple therapy. These treatments were significantly more effective in compliant than in non-compliant patients: 86% versus 44%, 90% versus 71%, and 93% versus 64%, respectively (p < 0.001). In the multivariate analysis, the variable most significantly associated with higher effectiveness was adequate compliance (odds ratio, 6.3 [95%CI, 5.2–7.7]; p < 0.001). Conclusions: Compliance with Helicobacter pylori eradication treatment is very good. Factors associated with poor compliance include uninvestigated/functional dyspepsia, rescue-treatment, prolonged treatment regimens, the presence of adverse events, and the use of non-bismuth sequential and concomitant treatment. Adequate treatment compliance was the variable most closely associated with successful eradication.

KW - adherence

KW - adverse effects

KW - bismuth

KW - dyspepsia

KW - effectiveness

KW - efficacy

KW - first line

KW - rate

KW - regimens

KW - rescue

UR - https://onlinelibrary.wiley.com/doi/10.1002/ueg2.12569

UR - https://www.scopus.com/pages/publications/85191845182

U2 - 10.1002/ueg2.12569

DO - 10.1002/ueg2.12569

M3 - Article

C2 - 38685613

SN - 2050-6406

VL - 12

SP - 691

EP - 704

JO - United European Gastroenterology Journal

JF - United European Gastroenterology Journal

IS - 6

ER -

Role of compliance in Helicobacter pylori eradication treatment: Results of the European Registry on H. pylori management

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