Pan-European Registry on H. Pylori Management (HP-EUREG): Interim Analysis of 5792 Patients

Abstract

Introduction: Due to the diversity of H. pylori strains, resistances and geographical particularities, the most efficient management strategy is still to be found. Aim: To systematically register the clinical practice of European gastroenterologists regarding H. pylori infection and treatment (31 countries, 250 recruiting investigators). Methods: A Local Coordinator was selected from each country with more than 10 H. pylori references in PubMed. Each Coordinator selected a representative group of recruiting investigators from its country. An e-CRF was created to systematically register all adult patients infected with H. pylori. Variables included: Patient’s demographics, previous eradication attempts, prescribed treatment, adverse events, and outcomes (cure rates, compliance and follow-up). Results: Up to now, 5792 patients have been included, and 3860 have finished follow-up. 58% females. 87% Caucasian. Mean age 57 years. 4.3% had drug allergies (77% to penicillin). 53% of indications were dyspepsia. 23% had gastroduodenal ulcer. 78% were treatment na€ıve, 16% second-line, 4.8% thirdline, 1.2% fourth-line, and 0.5% fifth-line. Culture was performed in 15% (57% resistant). 63% of prescriptions were triple regimens, 12% non-bismuth quadruple concomitant, 14% sequential, and 6.9% bismuth-quadruple. 47% of patients had adverse events, although mostly mild (62%) and short (6.7 days), causing discontinuation in 4.2% of cases. Given the great diversity of included regimens, detailed results for first-line, rescue treatments, and adverse events will be presented as separate abstracts. Conclusion: H. pylori management by gastroenterologists in Europe is extremely diverse, and in most settings suboptimal. Continuation of this registry may offer valuable information to improve this management.