UEG Poster

Standard Poster

Log in to continue.

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Log In Create a free account

Not sure what you can access? Learn more about account types.

FACTORS ASSOCIATED WITH THE LACK OF FOLLOW-UP IN HELICOBACTER PYLORI ERADICATION TREATMENT: RESULTS FROM THE EUROPEAN REGISTRY ON H. PYLORI MANAGEMENT (HP-EUREG)

Elisa Cantú-Germano 1, Leticia Moreira Ruiz 1, Ángeles Pérez-Aísa 2, Samuel Jesús Martínez-Domínguez 3, Irina Voynovan 4, Luis Bujanda Fernández de Piérola 5, Laimas Virginijus Jonaitis 6, Bojan Tepes 7, Ana Garre Vázquez 8, Alfredo J. Lucendo 9, Frode Lerang 10, Thomas Butler 11, Umud Mahmudov 12, Jose Maria Huguet 13, Javier Tejedor-Tejada 14, Pavel Bogomolov 15, Ian Beales 16, Perminder Phull 17, Manuel Pabon-Carrasco 18, Manuel Castro-Fernández 18, Sergei Alekseenko 19, Matteo Pavoni 20, Oleg Zaytsev 21, Renate Bumane 22, Maja Denkovski 23, Manuel Domínguez Cajal 24, Tatiana Ilchishina 25, Miguel Areia 26, Alma Keco-Huerga 18, Gülüstan Babayeva 27, Fernando Bermejo 28, Halis Simsek 29, Giuseppe Losurdo 30, Dmitry S. Bordin 31, Juozas Kupcinskas 6, Sinead Smith 32, Antonio Gasbarrini 33, Marcis Leja 22, Ricardo Pinto 34, Cem Simsek 35, Blas José Gómez-Rodríguez 36, Pilar Pazo Mejide 37, Ramón Pajares Villarroya 38, Mónica Sánchez Alonso 39, Anna Cano-Catala 40, Pablo Parra 8, Francis Mégraud 41, Colm O'Morain 32, Olga P. Nyssen 8, Javier P. Gisbert 8

Affiliations

1 Hospital Clínic de Barcelona, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBERehd), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain

2 Hospital Universitario Costa del Sol, Red de Investigación en Cronicidad, Atención Primaria y Prevención y Promoción de la Salud (RICAPPS), Marbella, Spain

3 Hospital Clínico Universitario Lozano Blesa, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Zaragoza, Spain

4 A.S. Loginov Moscow Clinical Scientific Center, Moscow, Russian Federation

5 Hospital Clínico Universitario Lozano Blesa, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), San Sebastián, Spain

6 Lithuanian University of Health Sciences, Kaunas, Lithuania

7 DC Rogaska, Rogaska Slatina, Slovenia

8 Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Universidad Autónoma de Madrid (UAM), and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain

9 Hospital General de Tomelloso, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM),

10 Østfold Hospital Trust, Grålum, Norway

11 Clinical Medicine, Trinity College Dublin, Department of Gastroenterology, Tallaght University Hospital, Dublin, Ireland

12 Modern Hospital, Baku, Azerbaijan

13 Hospital General Universitario de Valencia, Valencia, Spain

14 Hospital Universitario de Cabueñes, Gijón, Asturias, Spain

15 Universal Clinic Private Medical Center, Moscow, Russian Federation

16 Norwich Medical School, University of East Anglia, Norwich, United Kingdom

17 Aberdeen Royal Infirmary, Aberdeen, United Kingdom

18 Hospital Universitario Virgen de Valme, Sevilla, Spain

19 Fare Estern State Medical University, Khabarovsk, Russian Federation

20 Sant'Orsola-Malpighi University Hospital, Bologna, Italy

21 First Clinical Medical Centre, Kovrov, Russian Federation

22 Digestive Diseases Centre, Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia

23 Interni Oddelek, Diagnostic Centre, Bled, Slovenia

24 Hospital Universitario San Jorge, Huesca, Spain

25 SM-clinic, Saint-Petersburg, Russian Federation

26 Portuguese Oncology Institute of Coimbra, Faculty of Medicine of the University of Porto (FMUP), RISE@CI-IPO (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto), Coimbra, Portugal

27 Azerbaijan State Advanced Training Institute for doctors named after A.ALIYEV, Baku, Azerbaijan

28 Hospital Universitario de Fuenlabrada, Madrid, Spain

29 Hacettepe University, Department of Gastroenterology, HC International Clinic, Ankara, Türkiye

30 University of Bari, Bari, Italy

31 A. S. Loginov Moscow clinical scientific center, Department of outpatient therapy and family medicine, Tver State Medical University, Department of propaedeutic of internal diseases and gastroenterology, Moscow, Russian Federation

32 Trinity College Dublin, Dublin, Ireland

33 Fondazione Policlinico Universitario Gemelli IRCCS, Rome, Italy

34 Centro Hospitalar do Porto, Universidade do Porto, Instituto De Ciências Biomédicas de Abel Salazar, Center for Research in Health Technologies and Information Systems (CINTESIS, Porto, Portugal

35 Hacettepe University, Mehmet Akif Inan, Health Sciences University, Medical Center, HC International Clinic, Ankara, Türkiye

36 Hospital Universitario Virgen Macarena, Sevilla, Spain

37 Hospital de Cruces, Barakaldo, Spain

38 Hospital Universitario Infanta Sofía, Facultad de Medicina, Universidad Europea de Madrid, San Sebastián de los Reyes, Spain

39 Hospital Universitario Santa Bárbara, Puertollano, Spain

40 Gastrointestinal Oncology, Endoscopy and Surgery (GOES) research group, Althaia Xarxa Assistencial Universitària de Manresa, Institut de Recerca i Innovació en Ciències de la Vida i de la Salut de la Catalunya Central (IRIS-CC), Manresa, Spain

41 INSERM U1312, Université de Bordeaux, Bordeaux, France

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Abstract

Introduction

The Maastricht VI/Florence Consensus recommends eradication of all Helicobacter pylori (Hp) infections. However, retreatment strategies after therapeutic failure remain inconsistent.

Aims & Methods

To evaluate the reasons and associated factors for non-retreatment after a failure of Hp eradication treatment.
Systematic, prospective, multicenter, non-interventional registry of clinical practice by European gastroenterologists on the management of Hp infection (Hp-EuReg). Patients who failed eradication treatment between 2013-2024 and were registered in AEG-REDCap were analysed and categorised into two groups: retreatment (control group) and non-retreatment. Reasons for no retreatment were also classified according to either the medical or the patient perspective. Multivariate logistic regression was conducted to identify factors associated with no retreatment from both the patient and medical perspectives, each compared with the control group.

Results

Overall, 6,904 patients were evaluated; 950 (14%) were not retreated: 41% due to a medical decision, 50% due to a patient decision, and 9% due to other reasons. The most frequent reasons for no retreatment were: previous poor tolerance, unclear indication, multiple prior eradication attempts, and previous non-compliance. From the medical perspective, factors significantly associated with no retreatment were: age ≥ 71 years (OR 1.49; 95% CI 1.04-2.13), previous non-compliance (OR 4.27; 95% CI 2.64-6.93), number of previous attempts (OR 2.07-9.25; 95% CI from 1.57-2.73 to 6.15-13.93) and previous treatment discontinuation due to adverse events (OR 2.06; 95% CI 1.19-3.56). From the patient perspective, the factors significantly associated with no retreatment included: being male (OR 1.34; 95% CI 1.10-1.63), having undergone two to four previous eradication attempts (OR 1.69-3.60; 95% CI from 1.16-2.44 to 1.75-7.41) and previous non-compliance (OR 10.04; 95% CI 7.37-13.68).

Factors associated with the lack of H. pylori retreatment after a therapeutic failure – Multivariate analysis
	Retreatment N=5,954	No retreatment Overall N=950	P value OR (95% CI)_{if applicable}	No retreatment Medical perspective N=393	P value OR (95% CI)_{if applicable}	No retreatment Patient perspective N=474	P value OR (95% CI)_{if applicable}
Sex Male Female	2,100 (35.3%) 3,850 (64.7%)	386 (40.6%) 564 (59.4%)	0.000 1.30 (1.12-1.50)	147 (37.4%) 246 (62.6%)	0.116 -	206 (43.5%) 268 (56.5%)	0.004 1.34 (1.10-1.63)
Age 18-70 > 70	5,455 (91.6%) 475 (7.9%)	851 (89.5%) 96 (10.1%)	0.015 1.35 (1.06-1.72)	350 (89.1%) 40 (10.2%)	0.028 1.49 (1.04-2.13)	430 (90.7%) 44 (9.3%)	0.282 -
Number of previous eradication attempts One Two Three Four Five	1.054 (17.7%) 334 (5.6%) 115 (1.9%) 42 (0.7%) 28 (0.5%)	181 (19.1%) 105 (11.1%) 63 (6.6%) 27 (2.8%) 13 (1.4%)	p < 0.05 in all 1.57 (1.30-1.89) 2.82 (2.21-3.61) 5.05 (3.63-7.03) 6.00 (3.61-9.96) 4.04 (4.97-7.41)	82 (20.9%) 61 (15.5%) 39 (9.9%) 12 (3.1%) 5 (1.3%)	p < 0.05 in all 2.07 (1.57-2.73) 4.89 (3.54-6.74) 9.25 (6.15-13.93) 7.84 (3.96-15.53) 4.73 (1.75-12.77)	82 (17.3%) 26 (5.5%) 21 (4.4%) 10 (2.1%) 5 (1.1%)	p < 0.05 only in 2-4 attempts - 1.69 (1.16-2.44) 2.91 (1.78-4.76) 3.60 (1.75-7.41) -
Treatment compliance*	5,647 (94.8%)	739 (77.8%)	0.000 6.07 (4.97-7.41)	303 (77.1%)	0.000 4.27 (2.64-6.93)	358 (75.5%)	0.000 10.04 (7.37-13.68)
Interruption due to AE	183 (3.1%)	109 (11.5%)	0.053 -	68 (17.3%)	0.010 2.06 (1.19-3.56)	39 (8.2%)	0.000 0.34 (0.22-0.55)

OR: odds ratio. CI: confidence interval. AE: adverse events.
* Compliance: > 90% of drug intake.

Conclusion

A significant proportion (14%) of European patients are not retreated after Hp eradication failure. Key barriers include advanced age, a history of poor treatment adherence, and multiple prior eradication failures. The decision to avoid re-treatment was frequently driven by patient-related factors, although medical reasons also played a relevant role, highlighting the importance of shared decision-making and enhanced patient education.

References

1. Gisbert JP, Alcedo J, Amador J, Bujanda L, Calvet X, Castro-Fernández M, et al. V Spanish Consensus Conference on Helicobacter pylori infection treatment. Gastroenterol Hepatol Engl Ed. mayo de 2022;45(5):392-417.
2. Malfertheiner P, Megraud F, Rokkas T, Gisbert JP, Liou JM, Schulz C, et al. Management of Helicobacter pylori infection: the Maastricht VI/Florence consensus report. Gut. septiembre de 2022;71(9):1724-62.
3. Banks M, Graham D, Jansen M, Gotoda T, Coda S, Di Pietro M, et al. British Society of Gastroenterology guidelines on the diagnosis and management of patients at risk of gastric adenocarcinoma. Gut. septiembre de 2019;68(9):1545-75.

Disclosure

Olga P. Nyssen has served as a speaker or has received research funding from Allergan, Mayoly Spindler, Richen, Biocodex and Juvisé.
Javier P. Gisbert has served as speaker, consultant, and advisory member for or has received research funding from Mayoly, Allergan/Abbvie, Diasorin, Richen, Juvisé, Biocodex.
The remaining authors declare no conflicts of interest.

Conference

UEG Week Berlin 2025

Topics

Stomach & H. Pylori

Submission format

Abstract

Session

H. pylori: From epidemiology to therapy (Posters)

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

More Like This:

EASL Clinical Practice Guidelines on vascular diseases of the liver

European Consensus Recommendations for Direct Cholangioscopy and Pancreatoscopy Using a Modified Delphi Process

Sebastian Stefanovic

HISTOPATHOLOGICAL CORRELATIONS OF TISSUE SOUND SPEED IN HEPATOCELLULAR CARCINOMA: A QUANTITATIVE ASSESSMENT USING ACOUSTIC MICROSCOPY

Hideki Ishizu

PAPILLARY LARGE BALLOON DILATATION VERSUS ENDOSCOPIC COMPLETE SPHINCTEROTOMY IN PATIENTS WITH LARGE COMMON BILE DUCT STONE(S) AND PERIAMPULLARY DIVERTICULUM

Mohammed Ahmed Hasuna Hemeda

FROM BURN TO TREATMENT: REVISITING THE NATURAL HISTORY OF PEPTIC ULCER DISEASE - A TERTIARY CENTER EXPERIENCE

Pedro Narra Figueiredo

EFFICACY OF ARGON PLASMA COAGULATION (APC) IN THE REDUCTION OF GASTROJEJUNAL ANASTOMOSIS FOR WEIGHT REGAIN AFTER ROUX-EN-Y GASTRIC BYPASS

Jose Miguel Esteban López-Jamar

PAD: periampullary diverticulum			* significant as P value≤ 0.05
	Odds ratio	95% CI	P value
The used technique	5.92	1.32 to 25.3	0.009∗
Stone (s) number	0.62	0.17 to 2.25	0.468
Stone (s) diameter (mm)	2.59	0.63 to 10.56	0.187
Type of PAD	1.32	0.65 to 2.67	0.437

Variables	Non-responders: (TWL < 5% at 3m) 14/36 (39%)	Responders: (TWL ≥ 5% at 3m) 22/36 (61%)	p value
BMI before RYGB (kg/m2)	44.5 ± 5	46.2 ± 4.1	0.270
BMI before APC (kg/m2)	36.3 ± 5.2	35.9 ± 5.5	0.824
BMI 1 year post-APC (kg/m2)	34.8 ± 5.1	31.7 ± 4.1	0.049
TWL (%) 3 months	1.4 ± 0.02	14.9 ± 0.07	0.001
TWL (%) 6 months	5.4 ± 0.08	11.7 ± 0.07	0.008
TWL (%) 12 months	3.7 ± 0.08	11.1 ± 0.08	0.009
Baseline GJA diameter (mm)	26.5 ± 5	26.7 ± 5.7	0.923
Final GJA diameter (mm)	15.8 ± 4.8	16.8 ± 5.3	0.577
RAD (%) median (IQR)	-39.3 (-50,-23)	-33.8 (-54.3, -19.2)	0.808

UEG's educational platform for gastroenterology education bringing recordings, courses, guidelines, and more together in one place.

Most popular content

Rate for better recommendations!