Introduction

The effect of Helicobacter pylori eradication (HPE) on body weight and lipid profile is not well known.

Aims & Methods

We prospectively enrolled 102 patients who were treated for H pylori eradication from Apr 2021 to Jan 2024 at a university hospital in Goyang, South Korea (Inje University Ilsan Paik Hospital). Patients who had active peptic ulcer were excluded. Patients’ body weight and lipid profile were measured before enrollment and 3 months after taking medications for HPE. The difference between before-and-after measurements were compared using the paired t-test. To test the difference in lipid profile, patients who had newly started lipid lowering drugs before the three-month follow-up visit were excluded from the analysis.

Results

Among 102 patients who were enrolled to treat H. pylori, 87 patients (46 males, 41 females) were followed up three months after taking HPE prescriptions. The median age was 59 years (range, 19-82). The baseline body mass index was 25.0 kg/m2 (range, 16.2-37.5). There were 39 patients (44.8%) who were using lipid lowering drugs at the baseline. Five patients who had started lipid lowering drugs before the follow-up visit were excluded when analyzing the lipid profile change. Hp eradication rate was 91.9% (80/87). The HPE regimen included triple therapy (n=46 [52.9%]), quadruple therapy (n=31 [35.6%]), and concomitant therapy (n=10 [11.5%]). The body weight decreased from mean 67.4 kg (95% confidence interval [CI], 64.7-70.0) to mean 66.9 kg (95% CI, 64.3-69.5; p = 0.079). Serum glucose decreased from mean 111.7 mg/dL (95% CI, 106.9-120.5) to mean 109.4 (95% CI, 104.1-114.5; p = 0.068). Total cholesterol decreased from mean 166.5 mg/dL (95% CI, 157.5-175.6) to mean 162.1 (95% CI, 152.7-171.5; p = 0.172). Low-density lipoprotein (LDL) cholesterol decreased from mean 93.4 mg/dL (95% CI, 84.9-101.8) to mean 84.2 (95% CI, 76.4-92.1; p = 0.009). High-density lipoprotein (HDL) cholesterol increased from mean 52.7 mg/dL (95% CI, 49.6-55.8) to mean 54.5 (95% CI, 51.2-57.9; p = 0.074). Triglyceride changed slightly from 120.0 mg/dL (95% CI, 105.3-134.7) to 122.4 mg/dL (95% CI, 103.9-140.9; p = 0.702). The number of non-Hp eradicated subjects was too small (n = 7) to compare the differences in body weight and lipid profile according to actual H. pylori eradication.

	Baseline, mean (95% CI)	3 month follow-up after H. pylori eradication, mean (95% CI)	P-value (before-and-after t-test)	Difference among HPE successful (n = 80), median (interquartile range)	Difference among HPE failed (n = 7), median (interquartile range)	P-value (according to H. pylori eradication)
Body weight (kg)	67.4 (64.7-70)	66.9 (64.3-69.5)	0.079	-0.15 (-1.55,1)	-1 (-2.8, 0)	0.386
Serum glucose (mg/dL)	111.7 (106.9-120.5)	109.4 (104.1-114.5)	0.068	-1 (-11, 7)	-14.5 (-18, 23)	0.465
Total cholesterol (mg/dL)	166.5 (157.5-175.6)	162.1 (152.7-171.5)	0.172	-5 (-17, 7)	14 (-13, 43)	0.770
LDL cholesterol (mg/dL)	93.4 (84.9-101.8)	84.2 (76.4-92.1)	0.009	-7 (-21, 6)	-1.5 (-70, 19)	0.264
HDL cholesterol (mg/dL)	52.7 (49.6-55.8)	54.5 (51.2-57.9)	0.074	1 (-3, 7)	3 (-1, 22)	0.113
Triglyceride (mg/dL)	120.0 (105.3-134.7)	122.4 (103.9-140.9)	0.702	-3 (-30, 31)	-12 (-44, -1)	0.507

Conclusion

In a short-term prospective study among Korean patients who were treated for H. pylori, there was a decrease in body weight and a favorable effect on serum lipid levels. The number of non-Hp eradicated subjects was too small to draw conclusions about the effect of successfully eradicated Hp on body weight and lipid profile. The long-term effect of HPE on body weight and lipid profile remains to be analyzed, and a randomized study is required to achieve non-biased results.

References

1. Effect of Helicobacter pylori Eradication on Body Weight: A Multicenter Propensity Score-matched Analysis in Korea. J Neurogastroenterol Motil. 2023 Jul 30; 29(3): 352–359.
2. Eradication of Helicobacter pylori alleviates lipid metabolism deterioration: a large-cohort propensity score-matched analysis. Lipids Health Dis 21, 34 (2022).

Introduction

The association between chronic Helicobacter pylori infection and hormone levels affecting food intake and obesity remains controversial. Thus, our aim was to investigate the long-term effect of H. pylori eradication on changes in ghrelin and leptin levels.

Aims & Methods

A total of 72 patients meeting the inclusion and exclusion criteria were enrolled (July 2020 to November 2022). Participants were randomly assigned to two treatment groups (group 1: 14-day regimen with esomeprazole, amoxicillin, and clarithromycin; group 2: 14-day regimen with esomeprazole, amoxicillin, metronidazole and colloidal bismuth subcitrate). We evaluated changes in insulin resistance (HOMA-IR score), body mass index (BMI) and serum levels of ghrelin and leptin (ELISA test) at baseline, two months, and one year following successful H. pylori eradication.

Results

Of the 72 patients included, 13.9% (10/72) did not complete the study protocol. Both treatment groups were similar at enrolment and showed no statistically significant differences (p = 0.332 for OLGIM stages; p = 0.583 and p= 0.696 for antrum and corpus atrophy respectively, p = 0.177 and p = 0.296 for antrum and corpus intestinal metaplasia respectively). No statistically significant changes were present in BMI (p = 0.910) and insulin resistance (p = 0.342) after H. pylori eradication. A statistically significant decrease in ghrelin serum levels was observed in both treatment groups (p < 0.001), but not in leptin serum levels (p = 0.309), as shown in Table 1.

Table 1. Changes in various parameters over time in the entire cohort.

	T1	T2	T3	p-value
Leptin (pg/ml)	8128.0 ± 8171.2	9207.1 ± 8255.7	9469.4 ± 7761.5	0.257
Ghrelin (pg/ml)	3963.9 ± 2270.8	3076.7 ± 1767.2	3160.5 ± 1875.2	< 0.001
Body mass index	27.0 ± 4.4	27.0 ± 4.3	26.8 ± 5.2	0.910
Waist circumference (cm)	92.8 ± 11.8	92.6 ± 12.0	93.7 ± 11.8	0.325
HOMA-IR	2.3 ± 2.1	2.2 ± 1.4	2.0 ± 1.1	0.342

T1 – at baseline, T2 – 2 months post-eradication, T3 – 1-year post-eradication

Conclusion

Successful eradication of chronic H. pylori gastritis decreased serum ghrelin levels regardless of the presence of gastric mucosal atrophy. Furthermore, no changes in BMI or waist circumference were detected after one year of follow-up, proving that H. pylori eradication is not related to weight gain through hormonal changes as previously hypothesized. These results reduce the fear that massive H. pylori eradication from the population could be associated with obesity.

References

1. Martin-Nunez GM, Cornejo-Pareja I. Clemente-Postigo M, Tinahones FJ, Moreno-Indias I. Helicobacter pylori Eradication Therapy Affect the Gut Microbiota and Ghrelin Levels. Front Med 2021;8:712908.
2. Yanagi H, Tsuda A, Matsushima M, Takahashi S, Ozawa G, Koga Y, et al. Changes in the gut microbiota composition and the plasma ghrelin level in patients with Helicobacter pylori-infected patients with eradication therapy. BMJ Open Gastro 2017;4:e000182.
3. Roper J, Francois F, Shue PL, Mourad MS, Pei Z, Olivares de Perez AZ, et al. Leptin and ghrelin in relation to Helicobacter pylori status in adult males. J Clin Endocrinol Metab 2008;93: 2350-2357.
4. Nwokolo CU, Freshwater DA, O'Hare P, Randeva HS. Plasma ghrelin following cure of Helicobacter pylori. Gut 2003;52:637–40.

Disclosure

None of the authors have any conflict of interest regarding this study.
KT was a speaker for Abbvie, Pfizer, Krka, Altamedics, Viatris, Eli Lilly.
BT served as a speaker or received research grant from KRKA, Ewopharma, Swixx pharma, Infai GmbH.
RO was speaker for Abbvie, Lek Sandoz, Medis, Ewopharma, Polymetria, Nutricia.
ML, UPF, GA and DŠ have no conflict of interest to declare.

Introduction

Helicobacter pylori (Hp) infection is highly prevalent in Portugal, affecting over 60% of the population. Antibiotic resistance poses a significant challenge to Hp treatment; however, empirical regimens remain the standard of care over susceptibility-guided approaches. This study aims to evaluate the most recommended therapeutic options for Hp eradication and to identify risk factors associated with treatment failure.

Aims & Methods

Prospective cohort study conducted in a single centre, including all patients treated for Hp infection between 2013 and 2024. We analysed four eradication regimens: triple therapy (Tri), bismuth quadruple therapy (QuadB), concomitant quadruple therapy (QuadC) and sequential quadruple therapy (QuadS). We collected data on patient demographics and clinical characteristics and compared adherence rates, treatment effectiveness and incidence of adverse events.

Results

Included 591 patients, with a median age of 57 years (IQR 47-66) and female sex 57.2%. The main indication for Hp testing was dyspeptic symptoms (61.1%). The prescribed therapeutic regimens were QuadC in 34.0% of patients, QuadB in 32.8%, Tri in 23.2% and QuadS in 10.0%. According to the intention-to-treat analysis, QuadC (92.9%) and QuadB (90.4%) showed significantly higher eradication rates compared with Tri (73.9%, p<0.001), with no difference observed for QuadS (84.2%, p=0.30 vs QuadC; p=0.61 vs QuadB). Adverse events were significantly less frequent with Tri (0.06%) and QuadS (0.02%) compared to QuadC (0.18%, p<0.01) and QuadB (0.17%, p<0.05), but overall adherence to treatment was 97.1%, with no significant difference among regimens (p=0.19). Logistic regression identified predictive factors for treatment failure: prior eradication attempts (OR 2.31; 95% CI 0.3-1.4), poor adherence (OR 14.5; 95% CI 0.7-4.7) and absence of statin use (OR 2.33; 95% CI 0.07-1.6), with an AUC of 0.72.

Conclusion

QuadC and QuadB therapies are more effective for Hp eradication but are associated with increased rates of adverse events, without a negative impact on overall treatment adherence. Therapeutic failure is more likely in non-naive patients, those with poor adherence to treatment and without statin use.

Introduction

Helicobacter pylori (H. pylori) infection is the most prevalent infection worldwide, affecting more than half of the global population. It is the primary cause of chronic gastritis, peptic ulcer disease, and gastric cancer. Currently, most H. pylori eradication treatments are prescribed in Primary Care settings and are highly heterogeneous. However, the effectiveness of these treatments in real-world Primary Care settings remains suboptimal. Therefore, evaluating their effectiveness is essential to ensure optimal patient outcomes.

Aims & Methods

To assess the effectiveness of the different eradication treatment combinations prescribed in Primary Care, we conducted an epidemiological cohort study using data from BIFAP, a Spanish healthcare database containing real-world data on the clinical practice of Primary Care physicians.
A cohort study was conducted using real-world data from patients aged ≥18 years with a recorded H. pylori infection and a concomitant treatment prescription between 2003 and 2023. Treatment regimens were based on guideline-based recommendations compiled from Spanish and European Consensus Conferences between 1997 and 2022. Validated algorithms identified H. pylori infections and treatment patterns. Effectiveness was assessed based on stool antigen or breath test results documented within 12 months following treatment completion. A validation process was conducted to confirm the accuracy of laboratory test records through a manual review of a random sample of electronic health records. Effectiveness comparisons among treatments were made using Pearson’s c² test. A logistic regression was conducted to adjust for clinical factors associated with the success of each treatment combination. First-line treatment effectiveness was compared with that of the European Registry on H. pylori Management (Hp-EuReg) to contrast Primary and Specialised (Gastroenterologists) Care.

Results

A total of 211,972 patients with a recorded H. pylori infection, and, at least, one prescribed treatment pattern, were identified. Of these, 30,693 subjects (14%) met the criteria for inclusion in the effectiveness analysis. The median age was 55 years (IQR, 44–66), and 65% were women. The most frequently prescribed first-line regimen in both Primary and Specialised Care was proton pump inhibitor plus a single-capsule with bismuth, tetracycline and metronidazole (Pylera^®) (PPI+ScBQT). Pearson’s c² test confirmed significant (p < 0.01) differences in eradication rates among the regimens. PPI+ScBQT had the highest eradication rate (91%), followed by PPI + clarithromycin (C) + amoxicillin (A) + metronidazole (M) (88%), PPI+C+A (70%), and PPI+C+M (61%). The results aligned with data from Specialised care in the context of the Hp-EuReg. A logistic regression analysis was conducted to assess treatment effectiveness adjusted for relevant covariates, including age, sex, obesity, history of peptic ulcer, chronic kidney disease, and smoking status. After adjustment, PPI+ScBQT was confirmed as the most effective option, with significantly higher odds of eradication compared to the other regimens. The adjusted odds ratios (AOR) [95% confidence intervals] were: 0·15 [0·13–0·19] compared to PPI+C+M; 0·23 [0·21–0·24] compared to PPI+C+A; and 0·72 [0·66–0·79] compared to PPI+C+A+M.

Conclusion

In the Primary Care setting, single-capsule bismuth quadruple therapy showed the highest effectiveness, followed by non-bismuth concomitant quadruple therapy (PPI+C+A+M). These results were consistent with those reported in the Gastroenterology setting.

Disclosure

Javier P. Gisbert has served as speaker, consultant, and advisory member for or has received research funding from: Mayoly, Allergan/Abbvie, Diasorin, Richen, Juvisé and Biocodex.
Olga P. Nyssen received research funding from: Mayoly, Allergan/Abbvie, Richen, Juvisé and Biocodex.

Introduction

Helicobacter pylori (H. pylori) infection has a high prevalence (44.8%) in China and is an important risk factor of gastrointestinal diseases including gastric cancer. Bismuth quadruple therapy (BQT; bismuth + acid suppressant + 2 antibiotics [ABs]) is the currently recommended first-line regimen for H. pylori in China. Increasing AB resistance poses a vital challenge and remarkably reduces the eradication rate (ER) from 95% to 80% globally and 89% to 78% in China. Real-world ER analysis assessed only quadruple therapy in a few single centers and did not focus on different antibiotic combinations and other different regimens.

Aims & Methods

This study was designed to evaluate the diagnosis and treatment pattern of H. pylori infection and the effectiveness of eradication therapy in real-world settings in China. In this retrospective, multicenter study (NCT05073367), de-identified patient data were extracted from the electronic medical records database of 3 hospitals between January 1, 2019, and March 31, 2021. Patients aged ≥18 years with a record of H. pylori infection diagnosis were included. Here we presented the eradication rate of different treatment regimens and the eradication rate of different years with different treatment regimens.

Results

A total of 1426 patients received ET with efficacy evaluation duration＞4 weeks after the eradication therapy and the total eradication rate was 72.09% (n=1028). Most patients (80.36%; n=1146) received standard BQT with an ER of 76.70% (n=879). 158 patients (11.08%) received dual therapy (ER=56.96%; n=90) and 122 patients (8.56%) received triple therapy (ER=48.36%; n=59). Compared with triple and dual therapies, BQT was the predominant regimen in all the years with an ER of 77.86%, 67.64%, and 82.78% in 2019, 2020, and 2021, respectively. The ER of dual therapy was 50% in 2020 and 61.22% in 2021. The triple therapy ER showed a decreasing trend with 78.57% (n=11), 46.25% (n=37), 39.29% (n=11) from 2019 to 2021. Among the BQT regimens, amoxicillin plus furazolidone based regimens showed a higher ER (87.44%; n=181), while the ER of amoxicillin plus levofloxacin, amoxicillin plus clarithromycin based BQT was 77.94% (n=159) and 76.07% (n=391), respectively. Amoxicillin plus furazolidone based BQT showed a higher ER of 87.30%, 83.02%, and 90.11% in 2019, 2020, and 2021 respectively (Table 1).
Table 1. Eradication rate of H. pylori positive patients based on the type of eradication therapy

Total (N=1426) → /Treatment regimens ↓	ER-success n (%)b	Year 2019 Success n (%)b	Year 2020 Success n (%) b	Year 2021 Success n (%)b
Total	1028 (72.09)	454 (77.87)	253 (60.96)	321 (75.00)
Bismuth Quadruple Therapy Amoxicillin and Clarithromycin Amoxicillin and Furazolidone Amoxicillin and Levofloxacin Amoxicillin and Metronidazole Other Bismuth Quadruple Therapy	879 (76.70) 391 (76.07) 181 (87.44) 159 (77.94) 2 (50.00) 146 (67.28)	443 (77.86) 169 (78.24) 55 (87.30) 126 (79.25) 2 (50.00) 91 (71.65)	186 (67.64) 106 (67.95) 44 (83.02) 10 (55.56) 0 (0.00) 26 (54.17)	250 (82.78) 116 (81.69) 82 (90.11) 23 (85.19) 0 (0.00) 29 (69.05)
Triple therapyc Dual therapyc	59 (48.36) 90 (56.96)	11 (78.57) 0 (0.00)	37 (46.25) 30 (50.00)	11 (39.29) 60 (61.22)

Abbreviations: N, total number; n, number in respective category.
^a% = The total usage count of BQT/Triple therapy/Dual therapy eradication therapy/the total usage count of all standard eradication therapies taken by eligible participants. Of BQT, the total usage count of different BQT/the total usage count of all BQT.
^b% = The number of participants with a negative efficacy evaluation result/the number of participants receiving certain eradication therapy.
^cConsidering the table size, outcomes of different treatment regimens under dual and triple therapy were not included in the table.

Conclusion

BQT-based regimens were predominantly prescribed for H. pylori management and the current H. pylori treatment regimens have a suboptimal eradication rate in the real-world settings.

Disclosure

The study was funded by Takeda China. Wensheng Pan, Yan Zhao, and Hongwei Xu have no conflicts of interest. Pengfei Li, Fang Zhou, and Li Xie are employees of Takeda, and they hold Takeda stock options. Medical writing for the development of this abstract was provided by Swathirajan CR, PhD, and Kusuma Kumari G, PhD, of Indegene Private Limited, and funded by Takeda China. Authors retained full control of the abstract content.

Introduction

Helicobacter pylori (H. pylori) infection remains a major public health problem. Given the high resistance to antibiotics, different treatment strategies must be validated in each specific country. The recurrence rates of H. pylori infection and its predictors remain unclear.

Aims & Methods

To determine the independent factors predicting recurrence after successful eradication with a first-line treatment for H. pylori infection.
All patients were submitted to eradication treatment with five quadruple therapies (A-Concomitant with metronidazole 500mg tid, 14 days; B-Concomitant with metronidazole 500mg bid, 14 days; C-Quadruple with bismuth, 10 days; D-Sequential, 14 days; E-Hybrid, 14 days)) in a blind, randomized trial. Esomeprazole was the proton-pump inhibitor of choice. Efficacy rate at 1-2 months and recurrence rate at 12 months using ¹³C-urea breath test were evaluated. Sociodemographic data, personal/family history, health status and biochemical parameters were assessed using univariate and multivariate analyses.

Results

A total of 126 patients (42.9% males; mean age: 57.4±16.7 years) concluded the treatment protocol (A-25; B-21; C-27; D-24; E-29). Overall efficacy rate of quadruple therapy regimens was 98.4%(n=124): Group A-100%; Group B-100.0%; Group C-100.0%; Group D-100.0%; Group E-93.1% (p=0.147). Overall recurrence rate of quadruple therapy regimens was 4.1%(n=5/123): Group A-12.0%; Group B-9.5%; Group C-0.0%; Group D-0.0%; Group E-0.0% (p=0.009). After univariate/multivariate analysis, high LDL-cholesterol level (OR 1.032, p=0.042), non-bismuth concomitant H. pylori eradication regimen (OR 8.904, p=0.064) and alcoholism (OR 8.333, p=0.035) were independent risk factors for H. pylori reinfection.

Conclusion

In this South-European country, all quadruple therapy regimens with or without bismuth are very effective for H. pylori eradication. The 12-months recurrence rate of H. pylori infection after successful eradication is <5%. High LDL-cholesterol, non-bismuth concomitant H. pylori eradication regimen and alcoholism are independent predictors for H. pylori reinfection. A close surveillance on infectious state in high-risk patients is crucial to prevent long-term H. pylori-associated complications.

References

1. Zamani, M., Ebrahimtabar, F., Zamani, V., et al. (2018) Systematic review with meta-analysis: the worldwide prevalence of Helicobacter pylori infection. Aliment Pharmacol Ther 47(7), 868-876.
2. Malfertheiner, P., Megraud, F., O’Morain, C.A., et al. (2017) Management of Helicobacter pylori infection – the Maastricht V/Florence Consensus Report. Gut 66(1), 6-30.
3. Savoldi, A., Carrara, E., Graham, D.Y., et al. (2018) Prevalence of antibiotic resistance in Helicobacter pylori: a systematic review and meta-analysis in World Health Organization Regions. Gastroenterology 155(5), 1372-1382.
4. Lopo, I., Libânio, D., Pita, I., et al. (2018) Helicobacter pylori antibiotic resistance in Portugal: Systematic review and metaanalysis. Helicobacter 23(4), e12493.
5. Hu, Y., Wan, J.H., Li, X.Y., et al. Systematic review with meta-analysis: the global recurrence rate of Helicobacter pylori. Aliment Pharmacol Ther. 2017;46(9):773-779.
6. Zhao, H., Yan, P., Zhang, N., et al. The recurrence rate of Helicobacter pylori in recent 10 years: A systematic review and meta-analysis. Helicobacter. 2021;26(6):e12852.

Disclosure

None of the authors have anything to declare with regard to personal or financial interests in carrying out this work.

Introduction

Helicobacter pylori (H. pylori) is the most widespread infection globally and the main cause of chronic gastritis, peptic ulcer disease, and gastric cancer. Its eradication is primarily managed in primary care. Assessing real-world clinical management practices of H. pylori infection and their adherence to clinical guidelines is essential to inform and optimize treatment strategies.

Aims & Methods

To assess the current H. pylori management strategies followed in Primary Care, we conducted an epidemiological cohort study using data from BIFAP, a Spanish healthcare database containing real-world data on the clinical practice of Primary Care physicians.
Patients aged ≥18 years with a recorded H. pylori infection between January 1, 2003, and June 30, 2023, and a prescription for infection treatment were selected. Two algorithms were developed: one to identify potential cases of H. pylori infection, based on ICD-9/10, and SNOMED CT codes, supplemented by clue words; and another to detect prescribed treatment patterns, constructed from guideline-based recommendations compiled from Spanish and European Consensus Conferences between 1997 and 2022, encompassing 19 possible combinations. A validation process was conducted to confirm the accuracy of infection records through manual review of a random sample of electronic health records. Treatment prescriptions were validated based on active ingredients recorded. We analysed the treatment prevalence stratified by clinical and demographic factors. Continuous and categorical variables were summarized using medians and proportions, respectively. First-line treatments were compared with those of the European Registry on H. pylori Management (Hp-EuReg) to contrast Primary and Specialised (that is, gastroenterologists) Care, respectively.

Results

A total of 211,972 subjects were identified with a H. pylori infection record and, at least, one of the possible treatment patterns. The median age at infection diagnosis was 55 years (IQR, 44-66), with women representing 65%. The most frequent first-line treatments included: proton pump inhibitor (PPI) plus a single-capsule containing bismuth, tetracycline and metronidazole (Pylera®) (PPI+ScBQT) with 36% of cases; PPI, clarithromycin, amoxicillin (PPI+C+A) with 30%; and the combination PPI, clarithromycin, amoxicillin, metronidazole (PPI+C+A+M), with 26%. The most commonly used first-line combination among individuals aged 18-64 years was PPI+ScBQT, as well as in those with a recorded diagnosis of obesity, chronic kidney disease, and in current smokers. However, among individuals aged ≥65 years, as well as in those with a recorded diagnosis of peptic ulcer, the most frequent first-line treatment was PPI+C+A. Comparison between Specialised and Primary Care showed that, since 2013, the use of PPI+C+A by Gastroenterologists has decreased from 40% to less than 1% by 2023, with a similar trend observed in Primary Care, although it remains prescribed in over 10% of cases in 2023. The use of non-bismuth quadruple therapy (PPI+C+A+M) significantly increased since 2015, with a higher proportion in Specialised (40%) compared to Primary Care (30%). ScBQT is currently the most widely prescribed regimen, accounting for approximately 60% of prescriptions in both settings.

Conclusion

H. pylori eradication treatments in Primary Care are heterogeneous, with single-capsule bismuth quadruple therapy being the most prescribed. The use of first-line treatment guidelines has generally aligned with Spanish and European recommendations, although their adoption in Primary Care has been slower than in Specialised Care.

Disclosure

Javier P. Gisbert has served as speaker, consultant, and advisory member for or has received research funding from: Mayoly, Allergan/Abbvie, Diasorin, Richen, Juvisé and Biocodex.
Olga P. Nyssen received research funding from: Mayoly, Allergan/Abbvie, Richen, Juvisé and Biocodex.