Background: First-line Helicobacter pylori (H. pylori) treatments have been relatively well evaluated; however, it remains necessary to identify the most effective rescue treatments. Our aim was to assess the effectiveness and safety of H. pylori regimens containing rifabutin. METHODS: International multicentre prospective non-interventional European Registry on H. pylori Management (Hp-EuReg). Patients treated with rifabutin were registered in AEG-REDCap e-CRF from 2013 to 2021. Modified intention-to-treat and per-protocol analyses were performed. Data were subject to quality control. Results: Overall, 500 patients included in the Hp-EuReg were treated with rifabutin (mean age 52 years, 72% female, 63% with dyspepsia, 4% with peptic ulcer). Culture was performed in 63% of cases: dual resistance (to both clarithromycin and metronidazole) was reported in 46% of the cases, and triple resistance (to clarithromycin, metronidazole, and levofloxacin) in 39%. In 87% of cases rifabutin was utilised as part of a triple therapy together with amoxicillin and a proton-pump-inhibitor, and in an additional 6% of the patients, bismuth was added to this triple regimen. Rifabutin was mainly used in second-line (32%), third-line (25%), and fourth-line (27%) regimens, achieving overall 78%, 80% and 66% effectiveness by modified intention-to-treat, respectively. Compliance with treatment was 89%. At least one adverse event was registered in 26% of the patients (most frequently nausea), and one serious adverse event (0.2%) was reported in one patient with leukope-nia and thrombocytopenia with fever requiring hospitalisation. Conclusion: Rifabutin-containing therapy represents an effective and safe strategy after one or even several failures of H. pylori eradication treatment.

Experience with Rifabutin-Containing Therapy in 500 Patients from the European Registry on Helicobacter pylori Management (Hp-EuReg) / Nyssen O.P.; Vaira D.; Saracino I.M.; Fiorini G.; Caldas M.; Bujanda L.; Pellicano R.; Keco-Huerga A.; Pabon-Carrasco M.; Susanibar E.O.; Di Leo A.; Losurdo G.; Perez-Aisa A.; Gasbarrini A.; Boltin D.; Smith S.; Phull P.; Rokkas T.; Lamarque D.; Cano-Catala A.; Puig I.; Megraud F.; O'morain C.; Gisbert J.P.. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - ELETTRONICO. - 11:6(2022), pp. 1658.1-1658.13. [10.3390/jcm11061658]

Experience with Rifabutin-Containing Therapy in 500 Patients from the European Registry on Helicobacter pylori Management (Hp-EuReg)

Vaira D.;Saracino I. M.;Fiorini G.;
2022

Abstract

Background: First-line Helicobacter pylori (H. pylori) treatments have been relatively well evaluated; however, it remains necessary to identify the most effective rescue treatments. Our aim was to assess the effectiveness and safety of H. pylori regimens containing rifabutin. METHODS: International multicentre prospective non-interventional European Registry on H. pylori Management (Hp-EuReg). Patients treated with rifabutin were registered in AEG-REDCap e-CRF from 2013 to 2021. Modified intention-to-treat and per-protocol analyses were performed. Data were subject to quality control. Results: Overall, 500 patients included in the Hp-EuReg were treated with rifabutin (mean age 52 years, 72% female, 63% with dyspepsia, 4% with peptic ulcer). Culture was performed in 63% of cases: dual resistance (to both clarithromycin and metronidazole) was reported in 46% of the cases, and triple resistance (to clarithromycin, metronidazole, and levofloxacin) in 39%. In 87% of cases rifabutin was utilised as part of a triple therapy together with amoxicillin and a proton-pump-inhibitor, and in an additional 6% of the patients, bismuth was added to this triple regimen. Rifabutin was mainly used in second-line (32%), third-line (25%), and fourth-line (27%) regimens, achieving overall 78%, 80% and 66% effectiveness by modified intention-to-treat, respectively. Compliance with treatment was 89%. At least one adverse event was registered in 26% of the patients (most frequently nausea), and one serious adverse event (0.2%) was reported in one patient with leukope-nia and thrombocytopenia with fever requiring hospitalisation. Conclusion: Rifabutin-containing therapy represents an effective and safe strategy after one or even several failures of H. pylori eradication treatment.
2022
Experience with Rifabutin-Containing Therapy in 500 Patients from the European Registry on Helicobacter pylori Management (Hp-EuReg) / Nyssen O.P.; Vaira D.; Saracino I.M.; Fiorini G.; Caldas M.; Bujanda L.; Pellicano R.; Keco-Huerga A.; Pabon-Carrasco M.; Susanibar E.O.; Di Leo A.; Losurdo G.; Perez-Aisa A.; Gasbarrini A.; Boltin D.; Smith S.; Phull P.; Rokkas T.; Lamarque D.; Cano-Catala A.; Puig I.; Megraud F.; O'morain C.; Gisbert J.P.. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - ELETTRONICO. - 11:6(2022), pp. 1658.1-1658.13. [10.3390/jcm11061658]
Nyssen O.P.; Vaira D.; Saracino I.M.; Fiorini G.; Caldas M.; Bujanda L.; Pellicano R.; Keco-Huerga A.; Pabon-Carrasco M.; Susanibar E.O.; Di Leo A.; Losurdo G.; Perez-Aisa A.; Gasbarrini A.; Boltin D.; Smith S.; Phull P.; Rokkas T.; Lamarque D.; Cano-Catala A.; Puig I.; Megraud F.; O'morain C.; Gisbert J.P.
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