TY - JOUR
T1 - PROBIOTICS PRESCRIBED WITH HELICOBACTER PYLORI ERADICATION THERAPY IN EUROPE
T2 - USAGE PATTERN, EFFECTIVENESS, AND SAFETY: Results from the European Registry on Helicobacter pylori Management (Hp-EuReg)
AU - on behalf of the Hp-EuReg investigators
AU - Deza, Diego Casas
AU - Alcedo, Javier
AU - Lafuente, Miguel
AU - López, F. Javier
AU - Perez-Aisa, Ángeles
AU - Pavoni, Matteo
AU - Tepes, Bojan
AU - Jonaitis, Laimas
AU - Castro-Fernandez, Manuel
AU - Pabón-Carrasco, Manuel
AU - Keco-Huerga, Alma
AU - Voynovan, Irina
AU - Bujanda, Luis
AU - Lucendo, Alfredo J.
AU - Jurecic, Natasa Brglez
AU - Denkovski, Maja
AU - Vologzanina, Ludmila
AU - Rodrigo, Luis
AU - Martínez-Domínguez, Samuel J.
AU - Fadieienko, Galyna
AU - Huguet, Jose M.
AU - Abdulkhakov, Rustam
AU - Abdulkhakov, Sayar R.
AU - Alcaide, Noelia
AU - Velayos, Benito
AU - Hernández, Luis
AU - Bordin, Dmitry S.
AU - Gasbarrini, Antonio
AU - Kupcinskas, Juozas
AU - Babayeva, Gülüstan
AU - Gridnyev, Oleksiy
AU - Leja, Mārcis
AU - Rokkas, Theodore
AU - Marcos-Pinto, Ricardo
AU - Lerang, Frode
AU - Boltin, Doron
AU - Mestrovic, Antonio
AU - Smith, Sinead M.
AU - Venerito, Marino
AU - Boyanova, Lyudmila
AU - Milivojevic, Vladimir
AU - Doulberis, Michael
AU - Kunovsky, Lumir
AU - Parra, Pablo
AU - Cano-Català, Anna
AU - Moreira, Leticia
AU - Nyssen, Olga P.
AU - Megraud, Francis
AU - Morain, Colm O.
AU - Gisbert, Javier P.
N1 - Publisher Copyright:
© 2025 by The American College of Gastroenterology.
PY - 2025
Y1 - 2025
N2 - Aim: To evaluate the prescriptions patterns, effectiveness, and safety of adding probiotics to Helicobacter pylori eradication therapy, in Europe. Design: International, prospective, non-interventional registry of the clinical practice of the European gastroenterologists. Data were collected and quality reviewed until March 2021 at AEG-REDCap. The effectiveness was evaluated by modified intention-to-treat analysis, differentiating by geographic areas. Adverse events (AE) were categorized as mild, moderate, and severe. Results: Overall, 36,699 treatments were recorded, where 8,233 (22%) were prescribed with probiotics. Probiotics use was associated with higher effectiveness in the overall analysis (OR 1.631 [95% CI 1.456-1.828]), as well as in triple (1.702 [1.403-2.065]), quadruple (1.383 [0.996-1.920]), bismuth quadruple (1.248 [1.003-1.554] and sequential therapies (3.690 [2.686-5.069]). Lactobacillus genus was associated with a higher therapy effectiveness in Eastern Europe when triple (OR: 2.625 [CI 1.911, 3.606]) and bismuth quadruple (OR: 1.587 [CI 1.117, 2.254]) first-line therapies were prescribed. In Central Europe, the use of probiotics was associated with a decrease in both the overall incidence of AEs (0.656 [0.516, 0.888]) as well as severe AEs (0.312; [0.217, 0.449]). Bifidobacterium genus was associated with lower overall (OR: 0.725 [95% CI 0.592-0.888]) and severe (OR: 0.254 [0.185-0.347]) AEs; and Saccharomyces was associated with reduced overall (OR: 0.54 [CI 0.32-0.91]) and severe (OR 0.257 [CI 0.123-0.536]) AEs under quadruple-bismuth regimen. Conclusions: In Europe, the use of probiotics was associated with higher effectiveness and safety of H. pylori eradication therapy. Lactobacillus improved treatment effectiveness, while Bifidobacterium and Saccharomyces were associated with a better safety profile.
AB - Aim: To evaluate the prescriptions patterns, effectiveness, and safety of adding probiotics to Helicobacter pylori eradication therapy, in Europe. Design: International, prospective, non-interventional registry of the clinical practice of the European gastroenterologists. Data were collected and quality reviewed until March 2021 at AEG-REDCap. The effectiveness was evaluated by modified intention-to-treat analysis, differentiating by geographic areas. Adverse events (AE) were categorized as mild, moderate, and severe. Results: Overall, 36,699 treatments were recorded, where 8,233 (22%) were prescribed with probiotics. Probiotics use was associated with higher effectiveness in the overall analysis (OR 1.631 [95% CI 1.456-1.828]), as well as in triple (1.702 [1.403-2.065]), quadruple (1.383 [0.996-1.920]), bismuth quadruple (1.248 [1.003-1.554] and sequential therapies (3.690 [2.686-5.069]). Lactobacillus genus was associated with a higher therapy effectiveness in Eastern Europe when triple (OR: 2.625 [CI 1.911, 3.606]) and bismuth quadruple (OR: 1.587 [CI 1.117, 2.254]) first-line therapies were prescribed. In Central Europe, the use of probiotics was associated with a decrease in both the overall incidence of AEs (0.656 [0.516, 0.888]) as well as severe AEs (0.312; [0.217, 0.449]). Bifidobacterium genus was associated with lower overall (OR: 0.725 [95% CI 0.592-0.888]) and severe (OR: 0.254 [0.185-0.347]) AEs; and Saccharomyces was associated with reduced overall (OR: 0.54 [CI 0.32-0.91]) and severe (OR 0.257 [CI 0.123-0.536]) AEs under quadruple-bismuth regimen. Conclusions: In Europe, the use of probiotics was associated with higher effectiveness and safety of H. pylori eradication therapy. Lactobacillus improved treatment effectiveness, while Bifidobacterium and Saccharomyces were associated with a better safety profile.
KW - Bifidobacterium
KW - Helicobacter pylori
KW - Lactobacillus
KW - Probiotics
KW - Saccharomyces
KW - effectiveness
KW - eradication therapy
KW - safety
UR - http://www.scopus.com/inward/record.url?scp=85218010082&partnerID=8YFLogxK
U2 - 10.14309/ajg.0000000000003351
DO - 10.14309/ajg.0000000000003351
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C2 - 39902822
AN - SCOPUS:85218010082
SN - 0002-9270
JO - American Journal of Gastroenterology
JF - American Journal of Gastroenterology
M1 - 10.14309/ajg.0000000000003351
ER -