Comparison of the management of Helicobacter pylori infection between the older and younger European populations

Paulius Jonaitis, Olga P. Nyssen*, Ilaria Maria Saracino, Giulia Fiorini, Dino Vaira, Ángeles Pérez-Aísa, Bojan Tepes, Manuel Castro-Fernandez, Manuel Pabón-Carrasco, Alma Keco-Huerga, Irina Voynovan, Alfredo J. Lucendo, Ángel Lanas, Samuel J. Martínez-Domínguez, Enrique Alfaro Almajano, Luis Rodrigo, Ludmila Vologzanina, Natasa Brglez Jurecic, Maja Denkovski, Luis BujandaUmud Mahmudov, Mārcis Leja, Frode Lerang, Gülüstan Babayeva, Dmitry S. Bordin, Antonio Gasbarrini, Juozas Kupcinskas, Oleksiy Gridnyev, Theodore Rokkas, Ricardo Marcos-Pinto, Perminder S. Phull, Sinead M. Smith, Ante Tonkić, Doron Boltin, György Miklós Buzás, Štěpán Šembera, Halis Şimşek, Tamara Matysiak-Budnik, Vladimir Milivojevic, Wojciech Marlicz, Marino Venerito, Lyudmila Boyanova, Michael Doulberis, Lisette G. Capelle, Anna Cano-Català, Leticia Moreira, Francis Mégraud, Colm O’Morain, Javier P. Gisbert, Laimas Jonaitis

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


The prevalence of Helicobacter pylori remains high in the older population. Specific age-related peculiarities may impact the outcomes of H. pylori treatment. The aim of the study was to evaluate the diagnostics and effectiveness of H. pylori eradication between the younger and older European populations. “European Registry on H. pylori Management (Hp-EuReg)” data from 2013 to 2022 were analyzed. Patients were divided into older (≥ 60 years) and younger (18–59 years) groups. Modified intention-to-treat (mITT) and per-protocol (PP) analysis was performed. 49,461 patients included of which 14,467 (29%) were older-aged. Concomitant medications and penicillin allergy were more frequent among the older patients. Differences between younger and older populations were observed in treatment duration in first-line treatment and in proton pump inhibitors (PPIs) doses in second-line treatment. The overall incidence of adverse events was lower in the older adults group. The overall first-line treatment mITT effectiveness was 88% in younger and 90% in the older patients (p < 0.05). The overall second-line mITT treatment effectiveness was 84% in both groups. The effectiveness of the most frequent first- and second-line triple therapies was suboptimal (< 90%) in both groups. Optimal efficacy (≥ 90%) was achieved by using bismuth and non-bismuth-based quadruple therapies. In conclusion, the approach to the diagnostics and treatment of H. pylori infection did not generally differ between younger and older patients. Main differences were reported in the concurrent medications, allergy to penicillin and adverse events both in first- and second-line treatment. Optimal effectiveness rates were mostly achieved by using bismuth and non-bismuth-based quadruple therapies. No clinically relevant differences in the effectiveness between the age groups were observed.

Original languageEnglish
Article number17235
JournalScientific Reports
Issue number1
StatePublished - Dec 2023


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