PMID- 35709773
OWN - NLM
STAT- MEDLINE
DCOM- 20220620
LR  - 20220620
IS  - 1784-3227 (Print)
IS  - 1784-3227 (Linking)
VI  - 85
IP  - 2
DP  - 2022 Apr-Jun
TI  - First-line therapies for H. pylori infection in Italy: a pooled-data analysis.
PG  - 295-299
LID - 10.51821/85.2.9680 [doi]
AB  - BACKGROUND: Curing H. pylori infection remains challenging, and the use of most 
      effective first-line therapy represents a therapeutic cornerstone. To monitor the 
      efficacy of first-line therapies in Italy, we designed a systematic review with 
      pooled- data analysis of data published in the last 15 years. METHODS: The search 
      was focused on standard regimens and adult patients. Studies that included 
      modified therapy regimens, pediatric patients, case series with less than 5 
      patients, and those in language other than English were excluded. RESULTS: A 
      total of 40 studies, with 74 therapeutic arms and 13,539 patients were evaluated. 
      Among the 14-day triple therapies, the combination with proton pump inhibitor 
      (PPI), clarithromycin and amoxicillin achieved the highest (77.9%) success rate, 
      whilst the lowest success rate (62.7%) was observed following the 14-day PPI, 
      clarithromycin and tinidazole regimen. The overall efficacy of triple therapies 
      significantly decreased from 75.7% to 72.1% in the last decade. Sequential (88.3% 
      on 3431 patients), concomitant (88.8% on 376 patients), and the bismuth-based 
      quadruple therapy with three-in-one capsule, containing bismuth subcitrate 
      potassium (140 mg), metronidazole (125 mg), tetracycline (125 mg) (90.4% on 999 
      patients) achieved similarly high eradication rates, but data on concomitant are 
      still limited. The bismuth-based was associated with the higher (38.7%) incidence 
      of side-effects. CONCLUSIONS: Data found that all triple therapies, irrespective 
      of drug combination and therapy duration, should be abandoned in Italy due to 
      their unacceptable low success rates. Monitoring the efficacy of standard 
      first-line therapies in other countries could be clinically useful for both 
      patients and clinicians.
CI  - (c) Acta Gastro-Enterologica Belgica.
FAU - De Francesco, V
AU  - De Francesco V
AD  - Gastroenterology Unit, 'Riuniti' Hospital, Foggia, Italy.
FAU - Zullo, A
AU  - Zullo A
AD  - Gastroenterology and Digestive Endoscopy, Nuovo Regina Margherita Hospital, Rome, 
      Italy.
FAU - Manta, R
AU  - Manta R
AD  - Gastroenterology and Digestive Endoscopy, 'Generale' Hospital, Perugia, Italy.
FAU - Pavoni, M
AU  - Pavoni M
AD  - Dept. of Medical and Surgical Sciences, S. Orsola Hospital, University of 
      Bologne, Bologne, Italy.
FAU - Saracino, I M
AU  - Saracino IM
AD  - Dept. of Medical and Surgical Sciences, S. Orsola Hospital, University of 
      Bologne, Bologne, Italy.
FAU - Fiorini, G
AU  - Fiorini G
AD  - Dept. of Medical and Surgical Sciences, S. Orsola Hospital, University of 
      Bologne, Bologne, Italy.
FAU - Giostra, F
AU  - Giostra F
AD  - Dept. of Medical and Surgical Sciences, University of Bologne; Bologne, Italy.
FAU - Monti, G
AU  - Monti G
AD  - Dept. of Medical and Surgical Sciences, University of Bologne; Bologne, Italy.
FAU - Vaira, D
AU  - Vaira D
AD  - Dept. of Medical and Surgical Sciences, S. Orsola Hospital, University of 
      Bologne, Bologne, Italy.
LA  - eng
PT  - Journal Article
PT  - Systematic Review
PL  - Belgium
TA  - Acta Gastroenterol Belg
JT  - Acta gastro-enterologica Belgica
JID - 0414075
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Proton Pump Inhibitors)
RN  - 140QMO216E (Metronidazole)
RN  - 804826J2HU (Amoxicillin)
RN  - H1250JIK0A (Clarithromycin)
RN  - U015TT5I8H (Bismuth)
SB  - IM
MH  - Adult
MH  - Amoxicillin/therapeutic use
MH  - Anti-Bacterial Agents/adverse effects
MH  - Bismuth/therapeutic use
MH  - Child
MH  - Clarithromycin/pharmacology/therapeutic use
MH  - Data Analysis
MH  - Drug Therapy, Combination
MH  - *Helicobacter Infections/drug therapy
MH  - *Helicobacter pylori
MH  - Humans
MH  - Metronidazole/therapeutic use
MH  - Proton Pump Inhibitors/pharmacology/therapeutic use
OTO - NOTNLM
OT  - Helicobacter pylor
OT  - antibiotic
OT  - first-line therapy
OT  - therapy regimens
OT  - treatment
COIS- The authors declare that they have no conflict of interest
EDAT- 2022/06/17 06:00
MHDA- 2022/06/22 06:00
CRDT- 2022/06/16 18:59
PHST- 2022/06/16 18:59 [entrez]
PHST- 2022/06/17 06:00 [pubmed]
PHST- 2022/06/22 06:00 [medline]
AID - 10.51821/85.2.9680 [doi]
PST - ppublish
SO  - Acta Gastroenterol Belg. 2022 Apr-Jun;85(2):295-299. doi: 10.51821/85.2.9680.