Empirical first-line treatment use and effectiveness trends in Europe in the period 2013- 2020: results from the European registry on H. pylori management (HP-EUREG)
التفاصيل البيبلوغرافية
العنوان:
Empirical first-line treatment use and effectiveness trends in Europe in the period 2013- 2020: results from the European registry on H. pylori management (HP-EUREG)
Background: The impact of consensus, prescription choices and efficacy trends on clinical practice over time has not been studied in depth. Methods: International multicenter prospective non-interventional registry aimed to evaluate the decisions and outcomes of H. pylori management by European gastroenterologists. All infected adult patients were registered at AEG-REDCap e-CRF up to February 2021. Modified intention-to-treat (mITT) and time trend analyses were performed. Results: So far 29, 634 first-line empirical prescriptions from 31 European countries have been included. Overall, the most common prescribed treatments in the 2013-20 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 2018/20. Non- bismuth concomitant therapy use decreased from 21% in 2013/14 to 13% in 2019/20, while Pylera® increased from 0-1% in 2014/2015 to 19% in 2019/20. An increase in the average duration of treatments from 11 to 13 days in 2013-2020, and of the daily dose of PPI, was identified (No trend was identified (data now shown) ; however, there was an 8% overall improvement in first-line mITT overall effectiveness from 2013 to 2020 (Table 1). Conclusions: European gastroenterological practice is constantly adapting to the newest published evidence and recommendations (reducing the use of triple therapies and increasing the duration of treatment and the dose of PPIs), with a subsequent progressive improvement in overall effectiveness.