| Popis |
Introduction: The impact of consensus, prescription choices, and efficacy trends on clinical practice over time has not been studied in depth. Aims & Methods: International, multicenter, prospective, noninterventional registry aimed to evaluate the decisions and outcomes of H. pylori management by European gastroenterologists. All infected adult patients were systematically registered at AEG-REDCap e-CRF from 2013 to December 2022. Variables included: previous eradication attempts, prescribed treatment, adverse events, effectiveness outcomes, by geographical region (east, south-east, centre, south-west and north). Modified intention-to-treat (mITT) and time trend analyses were performed. Data were subject to quality review. Results: So far, 59,689 patients from 32 European countries have been included, and 46,797 (78%) were first-line empirical prescriptions. Overall, the most common prescribed treatments in the 2013-22 period were triple therapies; however, a shift in antibiotic regimens was identified. Triple therapies decreased from over 50% of prescription in 2013/15 to less than 20% in 2020/22; likewise, non-bismuth concomitant therapy use decreased from 21% in 2013/14 to 13% in 2020/22, while three-in-one single-capsuleincreased from 0-1% in 2014/2015 to 21% in 2020/22. An increase in the average duration of treatments from 9.7 days in 2013 to 13 days in 2022 was identified, as well as in the use of high-dose of PPIs increasing from 17% in 2013 to 35% in 2022. Detailed description of most common treatments is shown in Table 1. Regarding the effectiveness of each specific treatment, no trend was identified (data now shown); however, there was a ?10% overall improvement in first-line mITT overall effectiveness from 85% to 93% in 10 years of evolution, both globally and in each geographic region, especially after the year 2018 (Table). Conclusion: European gastroenterological practice is constantly adapting to the newest published evidence and recommendations (reducing the use of triple therapies and increasing both the duration of treatment and the dose of PPIs), with a subsequent progressive improvement in overall effectiveness.
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